Shifting of output in a sense prosthesis

ABSTRACT

A method, including the action of operating a sense prosthesis, such as a retinal implant, according to a first operating regime while the recipient has a first fatigue level, and operating the sense prosthesis according to a second operating regime while the recipient has a second fatigue level that is greater than the first fatigue level.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a Divisional application U.S. patent applicationSer. No. 15/157,968, filed May 18, 2016, which claims priority toProvisional U.S. Patent Application No. 62/327,648, entitledDOWNSHIFTING OF OUTPUT IN A SENSE PROSTHESIS, filed on Apr. 26, 2016,naming Sean LINEAWEAVER of Gig Harbor, Wash. as an inventor, the entirecontents of each application being incorporated herein by reference intheir entirety.

BACKGROUND

People suffer from sensory loss, such as, for example, eyesight loss.Such people can often be totally blind or otherwise legally blind. Socalled retinal implants can provide stimulation to a recipient to evokea sight percept. In some instances, the retinal implant is meant topartially restore useful vision to people who have lost their vision dueto degenerative eye conditions such as retinitis pigmentosa (RP) ormacular degeneration.

Typically, there are three types of retinal implants that can be used torestore partial sight: epiretinal Implants (on the retina), subretinalImplants (behind the retina), and suprachoroidal implants (above thevascular choroid). Retinal implants provide the recipient with lowresolution images by electrically stimulating surviving retinal cells.Such images may be sufficient for restoring specific visual abilities,such as light perception and object recognition.

Still further, other types of sensory loss entail somatosensory andchemosensory deficiencies. There can thus be somatosensory implants andchemosensory implants that can be used to restore partial sense of touchor partial sense of smell and/or taste.

Another type of sensory loss is hearing loss, which may be due to manydifferent causes, generally of two types: conductive and sensorineural.Sensorineural hearing loss is due to the absence or destruction of thehair cells in the cochlea that transduce sound signals into nerveimpulses. Various hearing prostheses are commercially available toprovide individuals suffering from sensorineural hearing loss with theability to perceive sound. One example of a hearing prosthesis is acochlear implant.

Conductive hearing loss occurs when the normal mechanical pathways thatprovide sound to hair cells in the cochlea are impeded, for example, bydamage to the ossicular chain or the ear canal. Individuals sufferingfrom conductive hearing loss may retain some form of residual hearingbecause the hair cells in the cochlea may remain undamaged.

Individuals suffering from hearing loss typically receive an acoustichearing aid. Conventional hearing aids rely on principles of airconduction to transmit acoustic signals to the cochlea. In particular, ahearing aid typically uses an arrangement positioned in the recipient'sear canal or on the outer ear to amplify a sound received by the outerear of the recipient. This amplified sound reaches the cochlea causingmotion of the perilymph and stimulation of the auditory nerve. Cases ofconductive hearing loss typically are treated by means of boneconduction hearing aids. In contrast to conventional hearing aids, thesedevices use a mechanical actuator that is coupled to the skull bone toapply the amplified sound.

In contrast to hearing aids, which rely primarily on the principles ofair conduction, certain types of hearing prostheses, commonly referredto as cochlear implants, convert a received sound into electricalstimulation. The electrical stimulation is applied to the cochlea, whichresults in the perception of the received sound.

Many devices, such as medical devices that interface with a recipient,have structural and/or functional features where there is utilitarianvalue in adjusting such features for an individual recipient. One typeof medical device where there is utilitarian value in making suchadjustments is the above-noted cochlear implant. That said, other typesof medical devices, such as other types of hearing prostheses, and othertypes of prosthesis, such as a retinal implant, exist where there isutilitarian value in fitting such to the recipient.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments are described below with reference to the attached drawings,in which:

FIG. 1 is a perspective view of an exemplary hearing prosthesis in whichat least some of the teachings detailed herein are applicable;

FIG. 2 presents an exemplary functional schematic according to anexemplary embodiment;

FIG. 3 presents another exemplary functional schematic according toanother exemplary embodiment;

FIG. 4 resents an exemplary flowchart for an exemplary method accordingto an exemplary embodiment;

FIG. 5 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 6 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 7 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 8 presents an exemplary illustration of an exemplary phenomenonassociated with an exemplary embodiment;

FIG. 9 presents an exemplary illustration of another exemplaryphenomenon associated with an exemplary embodiment;

FIG. 10 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 11 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 12 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 13 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 14 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 15 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment;

FIG. 16 presents an exemplary functional schematic according to anexemplary embodiment;

FIG. 17 presents another exemplary flowchart for an exemplary methodaccording to an exemplary embodiment; and

FIG. 18 presents an exemplary functional schematic according to anexemplary embodiment.

DETAILED DESCRIPTION

At least some of the teachings detailed herein can be implemented inretinal implants. Accordingly, any teaching herein with respect to animplanted prosthesis corresponds to a disclosure of utilizing thoseteachings in/with a retinal implant, unless otherwise specified. Stillfurther, at least some teachings detailed herein can be implemented insomatosensory implants and/or chemosensory implants. Accordingly, anyteaching herein with respect to an implanted prosthesis can correspondto a disclosure of utilizing those teachings with/in a somatosensoryimplant and/or a chemosensory implant. That said, exemplary embodimentscan be directed towards hearing prostheses, such as cochlear implants.The teachings detailed herein will be described for the most part withrespect to cochlear implants or other hearing prostheses. However, inkeeping with the above, it is noted that any disclosure herein withrespect to a hearing prosthesis corresponds to a disclosure of utilizingthe associated teachings with respect to any of the other prosthesesdetailed herein or other prostheses for that matter.

FIG. 1 is a perspective view of a cochlear implant, referred to ascochlear implant 100, implanted in a recipient, to which someembodiments detailed herein and/or variations thereof are applicable.The cochlear implant 100 is part of a system 10 that can includeexternal components in some embodiments, as will be detailed below. Itis noted that the teachings detailed herein are applicable, in at leastsome embodiments, to partially implantable and/or totally implantablecochlear implants (i.e., with regard to the latter, such as those havingan implanted microphone). It is further noted that the teachingsdetailed herein are also applicable to other stimulating devices thatutilize an electrical current beyond cochlear implants (e.g., auditorybrain stimulators, pacemakers, etc.). Additionally, it is noted that theteachings detailed herein are also applicable to fitting and/or usingother types of hearing prostheses, such as by way of example only andnot by way of limitation, bone conduction devices, direct acousticcochlear stimulators, middle ear implants, etc. Indeed, it is noted thatthe teachings detailed herein are also applicable to so-called hybriddevices. In an exemplary embodiment, these hybrid devices apply bothelectrical stimulation and acoustic stimulation to the recipient. Anytype of hearing prosthesis to which the teachings detailed herein and/orvariations thereof can have utility can be used in some embodiments ofthe teachings detailed herein.

The recipient has an outer ear 101, a middle ear 105 and an inner ear107. Components of outer ear 101, middle ear 105, and inner ear 107 aredescribed below, followed by a description of cochlear implant 100.

In a fully functional ear, outer ear 101 comprises an auricle 110 and anear canal 102. An acoustic pressure or sound wave 103 is collected byauricle 110 and channeled into and through ear canal 102. Disposedacross the distal end of ear canal 102 is a tympanic membrane 104 whichvibrates in response to sound wave 103. This vibration is coupled tooval window or fenestra ovalis 112 through three bones of middle ear105, collectively referred to as the ossicles 106 and comprising themalleus 108, the incus 109, and the stapes 111. Bones 108, 109, and 111of middle ear 105 serve to filter and amplify sound wave 103, causingoval window 112 to articulate, or vibrate in response to vibration oftympanic membrane 104. This vibration sets up waves of fluid motion ofthe perilymph within cochlea 140. Such fluid motion, in turn, activatestiny hair cells (not shown) inside of cochlea 140. Activation of thehair cells causes appropriate nerve impulses to be generated andtransferred through the spiral ganglion cells (not shown) and auditorynerve 114 to the brain (also not shown) where they are perceived assound.

As shown, cochlear implant 100 comprises one or more components whichare temporarily or permanently implanted in the recipient. Cochlearimplant 100 is shown in FIG. 1 with an external device 142, that is partof system 10 (along with cochlear implant 100), which, as describedbelow, is configured to provide power to the cochlear implant, where theimplanted cochlear implant includes a battery that is recharged by thepower provided from the external device 142.

In the illustrative arrangement of FIG. 1, external device 142 cancomprise a power source (not shown) disposed in a Behind-The-Ear (BTE)unit 126. External device 142 also includes components of atranscutaneous energy transfer link, referred to as an external energytransfer assembly. The transcutaneous energy transfer link is used totransfer power and/or data to cochlear implant 100. Various types ofenergy transfer, such as infrared (IR), electromagnetic, capacitive, andinductive transfer, may be used to transfer the power and/or data fromexternal device 142 to cochlear implant 100. In the illustrativeembodiments of FIG. 1, the external energy transfer assembly comprisesan external coil 130 that forms part of an inductive radio frequency(RF) communication link. External coil 130 is typically a wire antennacoil comprised of multiple turns of electrically insulated single-strandor multi-strand platinum or gold wire. External device 142 also includesa magnet (not shown) positioned within the turns of wire of externalcoil 130. It should be appreciated that the external device shown inFIG. 1 is merely illustrative, and other external devices may be usedwith embodiments of the present invention.

Cochlear implant 100 comprises an internal energy transfer assembly 132which can be positioned in a recess of the temporal bone adjacentauricle 110 of the recipient. As detailed below, internal energytransfer assembly 132 is a component of the transcutaneous energytransfer link and receives power and/or data from external device 142.In the illustrative embodiment, the energy transfer link comprises aninductive RF link, and internal energy transfer assembly 132 comprises aprimary internal coil 136. Internal coil 136 is typically a wire antennacoil comprised of multiple turns of electrically insulated single-strandor multi-strand platinum or gold wire.

Cochlear implant 100 further comprises a main implantable component 120and an elongate electrode assembly 118. In some embodiments, internalenergy transfer assembly 132 and main implantable component 120 arehermetically sealed within a biocompatible housing. In some embodiments,main implantable component 120 includes an implantable microphoneassembly (not shown) and a sound processing unit (not shown) to convertthe sound signals received by the implantable microphone in internalenergy transfer assembly 132 to data signals. That said, in somealternative embodiments, the implantable microphone assembly can belocated in a separate implantable component (e.g., that has its ownhousing assembly, etc.) that is in signal communication with the mainimplantable component 120 (e.g., via leads or the like between theseparate implantable component and the main implantable component 120).In at least some embodiments, the teachings detailed herein and/orvariations thereof can be utilized with any type of implantablemicrophone arrangement.

Main implantable component 120 further includes a stimulator unit (alsonot shown) which generates electrical stimulation signals based on thedata signals. The electrical stimulation signals are delivered to therecipient via elongate electrode assembly 118.

Elongate electrode assembly 118 has a proximal end connected to mainimplantable component 120, and a distal end implanted in cochlea 140.Electrode assembly 118 extends from main implantable component 120 tocochlea 140 through mastoid bone 119. In some embodiments electrodeassembly 118 may be implanted at least in basal region 116, andsometimes further. For example, electrode assembly 118 may extendtowards apical end of cochlea 140, referred to as cochlea apex 134. Incertain circumstances, electrode assembly 118 may be inserted intocochlea 140 via a cochleostomy 122. In other circumstances, acochleostomy may be formed through round window 121, oval window 112,the promontory 123 or through an apical turn 147 of cochlea 140.

Electrode assembly 118 comprises a longitudinally aligned and distallyextending array 146 of electrodes 148, disposed along a length thereof.As noted, a stimulator unit generates stimulation signals which areapplied by electrodes 148 to cochlea 140, thereby stimulating auditorynerve 114.

FIG. 2 presents an exemplary high level functional schematic of anexemplary embodiment, with emphasis on an overall signal processingscheme utilized in at least some embodiments. As can be seen, a stimuluscapture device 210, which can correspond to an image sensor, such as adigital image sensor (e.g., CCD, CMOS), or a sound sensor, such as amicrophone, etc. The transducer of device 210 outputs a signal to thecomponents of the so-called front end 220, which amplifies and combinesthe signals from device 210, and, in some embodiments, can incorporateautomatic gain control (AGC). In an exemplary embodiment, component ofthe front-end can include amplifiers, and/or prefilters, etc.

Output from the front end 220 is provided to a filterbank 230, whichsplits the light or sound, depending on the embodiment, into multiplefrequency bands. With respect to embodiments directed towards hearingprostheses, the splitting emulates the behavior of the cochlea in anormal ear, where different locations along the length of the cochleaare sensitive to different frequencies. In at least some exemplaryembodiments, the envelope of each filter output controls the amplitudeof the stimulation pulses delivered to a corresponding electrode. Withrespect to hearing prostheses, electrodes positioned at the basal end ofthe cochlea (closer to the middle ear) are driven by the high frequencybands, and electrodes at the apical end are driven by low frequencies.In at least some exemplary embodiments, the outputs of filter bank 230are a set of signal amplitudes per channel or plurality of channels,where the channels are respectively divided into corresponding frequencybands.

As can be seen in FIG. 2, the functional schematic has been divided intoan input side and an output side. Accordingly, various references willbe made to “input stages” and “output stages.” As used herein, inputstages have at least the following functionalities: management of theinput, such as the utilization of feedback elimination algorithms wherea portion of the signal coming from capture device 210 is canceled anddata signal cancellation, where again, a portion of the signal fromcapture device 210 is canceled. In an exemplary embodiment, theaforementioned canceling can be utilized to achieve noise reduction, andtherefore, such cancellation that occurs on the input side correspondsto an input stage operation. Speech enhancement andbeamforming/directional sound capture techniques are also input sideprocesses. Of course, as noted above, the prefiltering and the filteringof filter bank 230 also entail the management of the input. Theutilization of signal/data compression, etc. so as to enable thesampling and selection block 240 to perform in a more efficient mannerand/or in a power conservancy mode is also included in the input sidesignal management.

The sampling and selection block 240 (on the output side) samples theoutput of the filter bank 230, such as the filterbank envelopes, anddetermines the timing and pattern of the stimulation on each electrode.In general terms, sampling and selection block 240 selects certainchannels as a basis for stimulation, based on the amplitude and/or otherfactors. Still in general terms, sampling and selection block 240determines how stimulation will be based on the channels correspondingto the divisions established by the filter bank 230. In at least someexemplary embodiments, the actions of the sampling and selection blockare executed by a so-called sound processor with respect to a hearingprosthesis.

In some exemplary embodiments, stimulation rates on each electrode(electrodes of a cochlear electrode array, for example) can range from250 to 3500 pulses per second, and embodiments include stimulation ratesat any value or range of values therebetween in 1 pulse per secondincrements (e.g., 350 pulses per second, 3333 pulses per second, 355 to941 pulses per second, etc.). In some other exemplary embodiments,stimulation rates on each electrode (electrodes of a retinal electrodeassembly for example) may range from 50 pulses to 2,500 pulses persecond, and embodiments include stimulation rates at any value or rangeof values therebetween in 1 pulse per second increments. In an exemplaryembodiment, the stimulation is applied in pulses having pulse widths of10 to 25 μs duration or any value or range of values therebetween in onemicrosecond increments. The amplitude mapping block 250 compresses thefilterbank envelopes to determine the current level of each pulse.Currents having utilitarian value can be in the range 100 to 1000 μA, orany value or range of values therebetween in 1 μA increments. Suchcurrent levels vary both amongst implant recipients and across theelectrode apparatus. With respect to a hearing prosthesis, amplitude andmapping block 250 is set by a clinician, or more accurately, thealgorithm that is utilized to set the current levels is set by theclinician, and the sound processor, using that algorithm, implements theamplitude of the stimulation based on that algorithm. The final block(final by way of example) is the encoder 260, which encodes the dataprovided from block 250, so that the data can be transmitted to thestimulator. In an exemplary embodiment, the data is encoded for thepurposes of transmission over a 5 MHz inductance link via atranscutaneous transmission to an implanted stimulator, and outputted(as represented by arrow 270) to the stimulator component thatstimulates the tissue of the recipient to evoke the vision and/orhearing percept.

The functional diagram of FIG. 2 presents the various blocks in a linearfashion. It is noted however, that in at least some exemplaryembodiments, this is done in a nonlinear fashion as well. Note furtherthat the output side functionalities can have various subfunctions thatcan be implemented and/or not implemented, depending on how theprosthesis is utilized. In this regard, FIG. 3 depicts an exemplaryfunctional schematic of an operation of at least a portion of the outputside stages as a conceptual amalgamation where input from the input sideenters the output side processing 300, which includes various blocks aswill now be detailed, which results in output 390 that is utilized toevoke a sensory percept, such as a hearing percept in this exemplaryembodiment.

More specifically, as can be seen, the output side processing 300includes a timing block 310. Timing block 310 is utilized to determinethe stimulation rate(s) that will be applied to the tissue stimulator,at least with respect to electrical stimulation. By way of example onlyand not by way of limitation, an electrode of a retinal implant may bestimulated at a rate of 1000 pulses per second, whereas in at least someexemplary embodiments, there may be utilitarian value to insteadstimulate at a rate of 500 pulses per second. Still further by way ofexample, with respect to a cochlear implant, an exemplary stimulationrate of given electrode that is being utilized to evoke a hearingpercept is at about 900 pulses per second, whereas in some alternateembodiments, there can be utilitarian value with respect to stimulatingat a rate of 500 pulses per second, a slower rate. In an exemplaryembodiment, stimulation can occur for a given electrode from about 5000,4750, 4500, 4250, 4000, 3750, 3500, 3250, 3000, 2750, 2500, 2250, 2000,1900, 1800, 1700, 1600, 1500, 1450, 1400, 1350, 1300, 1250, 1200, 1150,1100, 1050, 1000, 950, 900, 850, 800, 750, 700, 650, 600, 550, 500, 450,400, 350, 300, 250, 200, 150, 100 or 50 or any value or range of valuestherebetween in 1 pulse per second increments. To be clear, these datapoints/ranges are but exemplary (as is the case with respect to all ofthe data points detailed herein unless otherwise specified). In someembodiments, stimulation can occur for a given electrode at ranges abovethese values or below these values. As will be disclosed herein, anexemplary embodiment entails operating a sense prosthesis during a firsttemporal period where the stimulation rate occurs at about 900 pulsesper second, and then, due to a scenario that will be described ingreater detail below, operating the hearing prosthesis such that thestimulation rate occurs at about 500 pulses per second. Still further,in an exemplary embodiment, there can be a scenario where the hearingprosthesis is operated such that the stimulation rate that occurs isabout 700 pulses per second.

More specifically, now with reference to FIG. 4, there is an exemplaryalgorithm presented for an exemplary embodiment representing method 400.Method 400 includes method action 410, which entails operating a senseprosthesis according to a first operating regime while the recipient hasa first fatigue level. In an exemplary embodiment, the recipient isfatigued relative to that which is the case at a prior temporal period,as will be described below. In an exemplary embodiment, the senseprosthesis is operated such that the stimulation rate of an electrodethereof is more than 600 pulses per second and less than 800 pulses persecond. In an exemplary embodiment, the hearing prosthesis is operatedsuch that the electrode is stimulated at 700 pulses per second. In anexemplary embodiment, the sense prosthesis is operated such that thestimulation rate of an electrode is anywhere between 400 pulses persecond and 3000 pulses per second or any value or range of valuestherebetween in one pulse per second increments. This can be considereda first scenario of use, with a recipient is fatigued, such as, by wayof example, mentally fatigued. In an exemplary embodiment, “fatigued”entails a physiological state where the recipient effectively does notperform at a given task as well as he or she otherwise would have in anon-fatigued state. Some additional details of this will be described ingreater detail below.

Method 400 further includes method action 420, which entails operatingthe sense prosthesis according to a second operating regime while therecipient has a second fatigue level that is greater than the firstfatigue level. Here, the recipient is more fatigued than that which wasthe case during operation of the hearing prosthesis at the firstoperating regime. By “more fatigued,” it is meant that the recipient hasa physiological state that results in the recipient effectively notperforming a given task as well as he or she otherwise would have at thefirst fatigue level. Again, both fatigue levels are differentiated froma physiological state where there is no fatigue (a zero fatigue level).In an exemplary embodiment, the sense prosthesis is operated accordingto the second operating regime such that the stimulation rate of anelectrode thereof is less than 600 pulses per second. In an exemplaryembodiment, the hearing prosthesis is operated such that the electrodeis stimulated at 500 pulses per second. In an exemplary embodiment, thesense prosthesis is operated such that the stimulation rate of anelectrode is anywhere between 100 pulses per second and 1500 pulses persecond or any value or range of values therebetween in one pulse persecond increments. This can be considered a second scenario of use.

FIG. 5 depicts another exemplary algorithm for an exemplary embodiment.FIG. 5 represents method 500. Method 500 includes method action 510,which entails operating a sense prosthesis according to a thirdoperating regime while the recipient has a zero fatigue level. In anexemplary embodiment, this can entail operating the sense prosthesis atthe beginning of one's workday or at the beginning of one's school day,where the recipient is not fatigued (this as opposed to tired, or ascenario where the recipient worked late into the night or studied lateinto the night, where the recipient begins the workday and/or school dayin a fatigued state). Here, a zero fatigue level is a physiologicalstate where the recipient is, all things being equal, most capable toperform a given task at hand relative to any other state in which therecipient might be, if only as a matter of statistics (i.e., therecipient has a general ability to perform a given task in anun-fatigued state, and these general abilities decline as the level offatigue increases—it might be that even in a non-fatigued state, therecipient does not perform such tasks relatively well as compared to astatistically significant group—in this regard, the ability to performis subjective and relative to only the recipient).

In an exemplary embodiment, the third operating regime is an operatingregime such that the stimulation rate of an electrode of the senseprosthesis is more than 800 pulses per second. In an exemplaryembodiment, the hearing prosthesis is operated such that the electrodeis stimulated at 900 pulses per second. In an exemplary embodiment, thesense prosthesis is operated such that the stimulation rate of anelectrode is anywhere between 600 pulses per second and 5000 pulses persecond, or any value or range of values therebetween in one pulse persecond increments.

FIG. 6 presents another alternate algorithm for an exemplary embodiment.In FIG. 6, there is presented a flowchart for a method 600. As can beseen, method 600 includes method action 610, which entails operating asense prosthesis according to a third operating regime while therecipient has a zero fatigue level. With respect to the stimulationrates of the electrodes, in an exemplary embodiment, this could be astimulation rate of about 800, 900, or 1000 pulses per second. In anexemplary embodiment, this corresponds to the stimulation rate of above400 pulses per second or any value thereabove in one pulse per secondincrements.

Method 600 further includes method action 620, which entails operatingthe sense prosthesis according to the third operating regime while therecipient has a first fatigue level. Here, the first fatigue levelcorresponds to that detailed above—something that is effectively inbetween a zero fatigue level, and a greater fatigue level, where thelevels noticeably impact the recipient's ability to perform given tasks(e.g., such as listening/comprehending that to which he or she islistening). However, the stimulation rate is not changed from that whichwas the case while the recipient was at the zero fatigue level. (As willbe detailed below, in some exemplary embodiments, other features of thehearing prosthesis are utilized in a different manner while therecipient is at the first fatigue level other than the stimulationrate.) That is, here, the stimulation rates are unchanged, even thoughthe recipient is more fatigued than that which was the case duringmethod action 610. As can be seen, this method differentiates from themethod of FIG. 5 in that, with respect to the method of FIG. 6, whilethe recipient is at the first fatigue level, the stimulation rate usedis the same as that which was used during the zero fatigue level whereasin the method of FIG. 5, the stimulation rate was reduced when therecipient was at the first fatigue level relative to that which was thecase while the recipient was at the zero fatigue level. As will beunderstood, in these methods, reference to the first, second, and thirdoperating regimes corresponds to reference for naming purposes only.Here, there is no first operating regime—only a second and thirdoperating regime. Again, these are merely names for accounting purposes.

Method 600 further includes method action 630, which entails operatingthe sense prosthesis according to a second operating regime while therecipient has a second fatigue level that is greater than the firstfatigue level. In an exemplary embodiment, with respect to thestimulation rates of the electrodes, this could be a stimulation rate ofabout 300, 400, 500, 600, or 700 pulses per second. In an exemplaryembodiment, this corresponds to a stimulation rate of below 1500 pulsesper second or any value or range of values therebetween in one pulse persecond increments.

FIG. 7 presents another alternate algorithm for an exemplary embodiment.In FIG. 7, there is presented a flowchart for a method 700. As can beseen, method 700 includes method action 710, which entails operating asense prosthesis according to a third operating regime while therecipient has a zero fatigue level. With respect to the stimulationrates of the electrodes, in an exemplary embodiment, this could be astimulation rate of about 800, 900, or 1000 pulses per second. In anexemplary embodiment, this corresponds to the stimulation rate of above400 pulses per second or any value thereabove in one pulse per secondincrements.

Method 700 further includes method action 720, which entails operatingthe sense prosthesis according to a first operating regime while therecipient has a first fatigue level. Here, the first fatigue levelcorresponds to that detailed above—something that is effectively inbetween a zero fatigue level, and a greater fatigue level, where thelevels noticeably impact the recipient's ability to perform given tasks(e.g., such as listening/comprehending that to which he or she islistening). In an exemplary embodiment, with respect to the stimulationrates of the electrodes, this could be a stimulation rate of about 300,400, 500, 600, or 700 pulses per second. In an exemplary embodiment,this corresponds to a stimulation rate of below 1500 pulses per secondor any value or range of values therebetween in one pulse per secondincrements.

Method 600 further includes method action 730, which entails operatingthe sense prosthesis according to the first operating regime while therecipient has a second fatigue level that is greater than the firstfatigue level. Here, the stimulation rates are unchanged, even thoughthe recipient is more fatigued than that which was the case duringmethod action 720. As can be seen, this method differentiates from themethod of FIG. 5 in that in the method of FIG. 7, while the recipient isat the second fatigue level, the stimulation rate used is the same asthat which was used during the first fatigue level whereas in the methodof FIG. 5, the stimulation rate was reduced when the recipient was atthe second fatigue level relative to that which was the case while therecipient was at the first fatigue level. Corollary to the embodimentdetailed above with respect to FIG. 6, in some other embodiments, otherfeatures of the hearing prosthesis are changed so as to account for thesecond fatigue level other than adjusting the stimulation rate.

Corollary to the above, in an exemplary embodiment, the prosthesis canbe operated according to an operation regime in which the prosthesislimits a resulting stimulation rate of a tissue stimulator thatstimulates tissue to evoke a hearing and/or a vision percept relative tothat which is the case in another operating regime.

Still with reference to FIG. 3, output side processing 300 includes apulse width block 315. Pulse width block 315 determines the pulse widthsof the stimulation signals applied to the electrodes. In an exemplaryembodiment, the pulse width can be from about 75 μs, 70 μs, 65 μs, 60μs, 55 μs, 50 μs, 45 μs, 40 μs, 35 μs, 30 μs, 25 μs, 20 μs, 15 μs, 10μs, 5 μs, or any value or range of value therebetween in 1 μsincrements. As with the timing block 310, the hearing prosthesis can beoperated depending on a range of scenarios to have different pulsewidths as will be detailed herein by way of example only and not by wayof limitation.

In view of this feature of the exemplary sense prosthesis, it is notedthat in an exemplary embodiment, with respect to FIGS. 5-7 (the methodsthereof), the third operating regime corresponds to the smallest pulsewidth relative to the first and second operating regimes. The firstoperating regime can correspond to an operating regime where the pulsewidth is larger than that of the third operating regime. Still further,the second operating regime can correspond to an operating regime wherethe pulse width is larger than that of the third operating regime andthe first operating regime.

Still further, output side processing 300 includes compression block320. In an exemplary embodiment, the prosthesis utilizes a signalprocessing strategy that is consistent for most of its utilization time.That is, this can be considered to be a default speech processingstrategy. With respect to a hearing prosthesis, such can be the ACEprocessing strategy, or some other processing strategy that does notutilize perceptual coding concepts. That said, in some exemplaryscenarios, there can be utilitarian value with respect to utilizing adifferent processing strategy or otherwise implementing a modificationof the given processing strategy. In an exemplary embodiment, suchentails utilizing a processing strategy that utilizes psychophysicalprocessing strategies that utilize perceptual coding concepts that can,for example, take into account the fact that some environmental inputs(sound, light, etc.) are perceptually masked by other inputs (sound,light—this is sometimes referred to in the art as a masking phenomenon),and therefore need not be presented as stimulation components (audio,visual component, depending on the embodiment). Masking functionally canresult in fewer spectral components (or maxima) that are ultimatelycoded. In at least some exemplary embodiments of the embodimentsdetailed herein, the prosthesis changes from a non-psychophysicalprocessing strategy to a psychophysical processing strategy upon theoccurrence of a different scenario, again which will be detailed below.In an exemplary embodiment with respect to a hearing prosthesis, thepsychophysical sound processing strategies used in at least some ofthese exemplary embodiments utilize masking models to estimate effectsof the masking phenomena on a recipient, and in turn, to process andencode received sound information into corresponding encoded electronicsignals that may omit sounds that would be perceptually masked. Asimilar concept can be utilized with respect to light for a retinalprosthesis.

Accordingly, in an exemplary embodiment, there is a psychophysicalprocessing strategy, such as a sound processing strategy, can depend inpart on sound intensity parameters. FIG. 8 illustrates an example of animplementation of a masking model to achieve perceptual coding, whereina masker or masking sound (e.g., a nearby car horn) makes it difficultfor a person to hear a masked sound (e.g., words that are whispered tothe person). In this example, the louder sound masks the softer sound.Accordingly, in an exemplary embodiment, there is utilitarian value withrespect to eliminating the content of the masked sound from the output,at least in some exemplary scenarios. Alternatively or in addition tothis, in an exemplary embodiment, there is utilitarian value withrespect to eliminating the content of the masking sound from the output,at least in some exemplary scenarios. While this example has beendirected towards sound frequencies, in an exemplary embodiment, the sametheory/principle of operation is also applicable to light frequencies.

In view of the utilitarian aspects of the processing compression block320, in an exemplary embodiment, with reference to the methods of FIGS.5-7, in an exemplary embodiment, the third operating regime utilizes ageneral compression strategy, such as, by way of example only and not byway of limitation, with respect to a hearing prosthesis, the ACE soundprocessing strategy. In this regard, the hearing prosthesis utilizes aprocessing strategy that corresponds to the typical processing strategyutilized by that prosthesis. That is, during normal operation (mostoperation), the hearing prosthesis will utilize this particularprocessing strategy. It is only when the recipient becomes fatigued thatthe processing strategy is changed or otherwise modified. In thisregard, in an exemplary embodiment, the first operating regime cancorrespond to one that implements a modified ACE sound processingstrategy, known in the art as the ACE with MP3 superscript 000considerations, such as that detailed in U.S. Pat. No. 7,272,446 to JohnParker, who at the time that the application was filed (Aug. 21, 2001,by way of the PCT, and Aug. 21, 2000, by way of the priority Australianpatent application PQ 9528), performed his innovative work in Lane Cove,NSW, Australia, Mr. Parker being a citizen of Australia. In an exemplaryembodiment, the first operating regime can correspond to one thatimplements any modified sound processing strategy relative to that whichwas utilized during the zero fatigue level/that of the third operatingregime. Thus, the third operating regime with respect to methods 500-700can utilize an unmodified ACE/pure ACE sound processing strategy. Withrespect to the methods where the sense prosthesis is operated accordingto a first operating regime that is different from the third operatingregime while the recipient has a first fatigue level, this firstoperating regime can correspond to the above-noted modified ACEstrategy/ACE with MP3 superscript 000 considerations. With respect tothe methods where the sense prosthesis is operated according to thefirst operating regime while the recipient has a second fatigue level,this strategy is thus utilized while the recipient is at the secondfatigue level. That said, in alternate embodiments, such as those thatentail operating the sense prosthesis according to a second operatingregime while the recipient has a second fatigue level, a more aggressivecompression strategy than that which is achieved or otherwise utilizedby the strategy implemented during the first operating regime can beutilized. By way of example, the first operating regime can utilize a“light” version of the ACE with MP3 superscript 000 considerations, andthe second operating regime can utilize an “intense” or “aggressive”version of the ACE with MP3 superscript 000 considerations. Indeed, insome alternate embodiments, a completely different processing strategycan be implemented during the second operating regime providing that theteachings detailed herein and/or variations thereof can be practiced.Some additional details of such are described in greater detail below.

It is further noted that the masking models contemplated herein are notonly dependent on different sound intensities, but also on spectral andtemporal characteristics. Such spectral and temporal characteristicsare, in some embodiments, defined in part by various adjustableparameters, such as by way of example only and not by way of limitation,spectral masking slopes, temporal masking offsets, and the number ofspectral maxima.

With respect to the methods 500, 600, and 700 detailed above, the thirdoperating regime can permit or otherwise will permit more spectralmaxima than that of the first operating regime, and the first operatingregime can permit or otherwise will permit more spectral maxima thanthat of the second operating regime. This can be done in a quantitativemanner. In an exemplary embodiment, the third operating regime is anoperating regime where the number of spectral maxima that are presentedto the recipient is no more than 5, 6, 7, 8, 9, 10, 11, 12, 13, or 14,depending on the embodiment. Still further, in an exemplary embodiment,the first operating regime is an operating regime where the number ofspectral maxima that are presented to the recipient is no more than 3,4, 5, 6, 7, 8, or 9, depending on the embodiment. Also, in an exemplaryembodiment, the second operating regime is an operating regime where thenumber of spectral maxima that are presented to the recipient is no morethan 1, 2, 3, 4, 5, 6, or 7. In at least some exemplary embodiments, thespectral masking regulation block 330 is utilized to implement method500, where there are three different operating regimes for the twolevels of fatigue plus the zero level of fatigue. In this regard, in anexemplary embodiment, the operating regime for the zero level of fatiguecan correspond to a limit of 8 spectral maxima, the operating regime forthe first level of fatigue can correspond to a limit of 6 spectralmaxima, and the operating regime for the second level of fatigue cancorrespond to a limit of four spectral maxima (in an exemplaryembodiment). That said, in some alternate embodiments, the spectralmasking regulation block 330 is utilized to implement method 600 and/ormethod 700, where there are 2 different operating regimes for the twolevels of fatigue plus the zero level of fatigue.

That said, in alternate embodiments and methods 400-700, the managementof spectral maxima can be done in a manner that does not have a fixedquantitative value, but can achieve spectral masking based on the sizeof the given maxima. In this regard, as noted above, like 330, thespectral masking threshold regulation block. In this vein, output sideprocessing 300 includes spectral masking threshold regulation block 330.The spectral masking threshold regulation block adjusts a slope of themasking (the masking slope) to impact frequencies that are at eitherhigher or lower frequencies than an input at issue. FIG. 9 illustratesan example of how a left or lower frequency slope, and a right or higherfrequency slope can be defined with respect to a given maxima (see alsoFIG. 8 and how the masking slope defines a masking threshold).Generally, a relatively more aggressive masking slope corresponds to amore gradual (or less steep slope), which in turn functions to eliminatemore maxima from being encoded and provides a greater degree of masking.Accordingly, in an exemplary embodiment, the spectral masking thresholdregulation block 330 regulates the masking slope that will be utilizedwith respect to the output side. In some exemplary embodiments, theprosthesis will be utilized in some scenarios to have a slope that isless steep, more gradual than that which was the case in otherscenarios, thus eliminating spectral maximas that otherwise might bepresent with a steeper slope. Accordingly, in an exemplary embodiment,in a first operating regime, the spectral masking slope is greater (inabsolute value) than that of the second operating regime, and the thirdoperating regime utilizes a spectral masking slope that is greater thanthat of the first and second operating regimes. In an exemplaryembodiment, the slope of the third operating regime is more than about0.1, 0.15, 0.2, 0.25, 0.3, 0.4, 0.5, 0.75, 1.0, 1.25, 1.5, 1.75, 2.0,2.25, 2.5, 2.75, 3, 3.5, 4, 4.5, 5, 5.5, 6 times, or more than that ofthe first operating regime, or any value or range of values therebetweenin 0.01 increments, and the slope of the first operating regime is morethan about 0.1, 0.15, 0.2, 0.25, 0.3, 0.4, 0.5, 0.75, 1.0, 1.25, 1.5,1.75, 2.0, 2.25, 2.5, 2.75, 3, 3.5, 4, 4.5, 5, 5.5, 6 times, or morethan that of the second operating regime, or any value or range ofvalues therebetween in 0.01 increments.

Accordingly, in at least some exemplary embodiments, the third operatingregime is an operating regime that results in a spectral masking slopeof the prosthesis being steeper than that which is the case with respectto the first operating regime. Accordingly, in at least some exemplaryembodiments, the first operating regime is an operating regime thatresults in a spectral masking slope of the prosthesis being steeper thanthat which is the case with respect to the second operating regime. Thatsaid, in some exemplary embodiments, the third operating regime is anoperating regime that results in a spectral masking slope of theprosthesis that is the same as that which is the case with respect tothe first operating regime, but those slopes are steeper than that whichis the case with respect to the second operating regime. Still further,in some exemplary embodiments, the first and second operating regimesresult in spectral masking slopes of the prosthesis that are the same,whereas the third operating regime results in spectral masking slopes ofthe prosthesis that are steeper than that of the first and secondoperating regimes. Also, in view of the above, it can be understood thatthe hearing prosthesis can operate an operating regime where the hearingprosthesis limits the number of spectral maxima in an output signal to atissue stimulator that stimulates tissue to evoke a hearing and/or avision percept relative to that which is the case in another operatingregime.

Still further, with continuing reference to FIG. 3, as can be seen,output side processing 300 further includes a temporal maskingregulation block 335. In this regard, in an exemplary embodiment, theprosthesis can vary the temporal masking offsets that are utilizedduring exemplary scenarios (which includes implementing embodimentswhere there is no temporal offset—it is noted that all of the examplesherein include utilizing the prostheses without the implementation of afunctionality of a given block—for example, there can be no processingcompression, no spectral maxima regulation, no spectral maskingthreshold regulation, etc., in some scenarios).

More specifically, masking can also have a temporally forward and/orbackward impact. Forward masking occurs when the sound following amasker cannot be heard, and backward masking occurs when a maskerfollows the sound. With respect to a hearing prosthesis, a forwardmasker generally impacts sound thresholds approximately 100-200 msfollowing the masker, and a backward masker generally impacts soundthresholds approximately 10 ms prior to the masker. Similar concepts areapplicable for a vision prosthesis, such as a retinal implant. In thisregard, a forward masking offset of 200-250 ms is greater than a forwardmasking offset of 100-200 ms, and thus will eliminate more followinginput than the latter, and a backward masking offset of 150 ms isgreater than a backward masking offset of 100 ms, and thus willeliminate more prior input than the latter. Both latter offsets willresult in less data being provided to the recipient of the output of theprosthesis than that which would be the case with respect to therespective former offsets.

In an exemplary embodiment implementing method 500, the third operatingregime corresponds to that where the temporal masking offset is a zerotemporal masking offset (there is no temporal masking offset). The firstoperating regime corresponds to that where the temporal masking offsetis moderate, and the second operating regime corresponds to that wherethe temporal masking offset is aggressive, where the temporal offset forthe moderate is smaller than that for the aggressive. In an exemplaryembodiment, the offset utilized in the first operating regimecorresponds to a temporal offset that is about 0.05, 0.1, 0.15, 0.2,0.3, 0.4, 0.5, 0.6, 0.7, or 0.8 times the amount of that utilized in thesecond operating regime. With respect to embodiments that utilize onlytwo operating regimes for the two levels of fatigue plus the zero levelof fatigue, the moderate or the aggressive temporal masking offset canbe utilized. In an exemplary embodiment, the temporal masking offsetthat is utilized in the binary operating regime embodiment cancorrespond to any of those detailed herein.

Note further that in at least some exemplary embodiments, depending onthe scenario, forward masking and/or backward masking can be implementedwithout implementing the other. Still further, in an exemplaryembodiment, aggressive backward masking can be utilized while at thesame time moderate forward masking can be utilized, and vice versa. Anycombination of the temporal masking offset implementations can beutilized in at least some exemplary embodiments corresponding tooperating regimes that relate to fatigue level. Note further, that in atleast some exemplary embodiments, an operating regime implemented at thezero fatigue level (e.g., the third operating regime) can include sometemporal masking offset. In an exemplary embodiment, the temporalmasking offset is less than (the time is not as great) as those of theother two operating regimes. In an exemplary embodiment, the temporalmasking offset used during the third operating regime is about 0.01,0.02, 0.03, 0.04, 0.05, 0.075, 0.1, 0.125, 0.15, 0.175, 0.2, 0.25, 0.3,0.35, 0.4, 0.5, 0.6, 0.7, or 0.8 the temporal length of the firstoperating regime and/or in the second operating regime.

Again continuing with reference to FIG. 3, output side processing 300further includes spectral maxima regulation block 325. While theprocessing compression block 320 does result in fewer maxima due to thereduction in processing, embodiments, also can artificially limit thenumber of maxima of the given processing compression strategy resultingfrom block 320, relative to that which would be the case in the absenceof maxima regulation. In an exemplary embodiment, fewer maxima resultsin less stimulation relative to that which would be the case with moremaxima, all other things being equal.

Accordingly, in an exemplary embodiment, the prosthesis can be operatedin a regime where the number of spectral maxima is limited relative tothat which is the case with respect to operation during other scenarios.

As noted above, some exemplary embodiments utilize noise cancellationtechniques in the input side of the processing. Conversely, embodimentscan also utilize and/or instead utilize noise mitigation techniques onthe output side. With continued reference to FIG. 3, it can be seen thatthe output side processing 300 further includes qualitative output datamanagement block 340. In this regard, block 340 implements or otherwiseprovides stimulus mitigation/stimulus reduction in the form of stimulusreduction algorithms. In an exemplary embodiment, these stimulusreduction algorithms can reduce the amount of stimulus based on lightthat is captured that is provided to the recipient. In this regard,embodiments include light mitigation/light reduction algorithms. Withrespect to hearing prostheses, some exemplary embodiments include soundmitigation algorithms and sound reduction algorithms. It is noted thatin general, the processing strategies in at least some exemplaryembodiments that are directed to a hearing prosthesis, irrespective ofthe presence of block 340, employ a brightening (high-pass) filter tosuppress low-frequency audio information. That said, in some exemplaryembodiments, block 340 can implement adaptive dynamic range optimizationto focus processing on sound intensities that have a higher probabilityof being associated with sound that is deemed to be desired. Withrespect to vision prostheses, the processing strategy can also include abrightening strategy and/or a darkening strategy, with similarconceptual results. That said, in some exemplary embodiments, block 340can implement adaptive dynamic range optimization to focus processing onlight intensities that have a higher probability of being associatedwith light that is deemed to be desired.

In view of the above, in an exemplary embodiment, the first operatingregime corresponds to an operating regime where the prosthesis isoperated such that there is more noise mitigation than that whichresults in the third operating regime. Still further, in an exemplaryembodiment, the second operating regime corresponds to an operatingregime where the prosthesis is operated such that there is more noisemitigation than that which results in the first operating regime (andthus more noise mitigation than that which results in the thirdoperating regime). That said, in some exemplary embodiments, the noisemitigation that results in the operation of the prosthesis in the firstand second operating regimes is the same, but more so than that of thethird operating regime. Corollary to this is that in some exemplaryembodiments, the noise mitigation that results in the operation of theprosthesis at the first and third operating regimes is the same, butless so than that of the second operating regime. Note that with respectto embodiments where there is disclosure of the various results beingthe same (e.g., noise mitigation being the same), these are disclosed interms of relative samity. That is, all things being equal, the result isthe same. Accordingly, for the same captured environmental phenomenon(light, sound), the noise mitigation, for example, is the same, or moreaccurately, the prosthesis operates such that the noise mitigationshould be the same.

Thus, in an exemplary embodiment, such as an embodiment where theambient environment is bright (in the light sense) and/or noisy (in thesound sense), block 340 is utilized to focus processing on light and/orsound intensities that have a higher probability of being associatedwith moving objects, for example, and with speech, respectively, forexample, depending on the type of prosthesis in which the teachingsdetailed herein are implemented.

It is noted that block 340 is differentiated from the other types oflight and noise reduction that can achieve by single cancellation, orthe other types of light and noise management that can be achieved by,for example, beamforming, both of which are associated with input sideof the processing.

Accordingly, in an exemplary embodiment, block 340 is utilized indifferent manners depending on the given fatigue level or lack thereofof the recipient. In an exemplary embodiment, noise mitigation appliedduring the third operating regime is a standard noise mitigationimplementation, although in some other embodiments, the third regimeentails no noise mitigation (on the output side—this can still bepresent on the input side). Still further, in an exemplary embodiment,noise mitigation applied during the first operating regime is a moderatenoise mitigation as compared to that applied during the third operatingregime. It is noted that in some embodiments where the recipient is atthe second fatigue level, the moderate noise mitigation is utilized aswell. Conversely, in some alternate embodiments, where the recipient isat the second fatigue level, as well as the first fatigue level, theaggressive noise mitigation implementation is utilized. That said, insome alternate embodiments, no noise mitigation or standard noisemitigation is utilized while at the zero fatigue level and at the firstfatigue level, and the moderate or aggressive noise mitigation isutilized at the second fatigue level.

It is briefly noted at this time that while the embodiments detailedabove have focused on the utilization of three different levels—twolevels of fatigue in a zero level of fatigue, in an alternateembodiment, there can be four different levels or more. For example, ina method where the recipient is at a third level of fatigue greater thanthat of the second and first levels of fatigue, the aggressive noisemitigation can be used, while the moderate noise mitigation was utilizedat the second level of fatigue, and the standard level of noisemitigation was utilized at the first level of fatigue, and no mitigationof noise was utilized at the zero level of fatigue. Alternatively, astandard can be utilized at the zero level of fatigue, a moderate noisemitigation can be used at the first and second levels of fatigue, andthe aggressive noise mitigation can be utilized at the third level offatigue.

In the embodiment represented by FIG. 3, in some exemplary embodiments,the output side processing 300 further includes a relative datamanagement block 345. In an exemplary embodiment, relative datamanagement block 345 manages the output of the hearing prosthesis, ormore accurately, processes on the output side the output of the hearingprosthesis such that the output is relativized. By way of example onlyand not by way of limitation, embodiments can utilize light growth andloudness growth functions. With respect to loudness growth (identifiedas the Q factor in the art), loudness growth defines how the acousticdynamic range is mapped into electric output. This corresponds to therole acoustic dynamic range that the processing can optimize. However,in at least some exemplary embodiments, when Q values increase, moreinformation is mapped onto the audible levels. This can entailincreasing the amount of “noisy” information that is mapped onto theaudible levels. In at least some exemplary embodiments, this can have adeleterious effect in that the noisy information can crowd out theinformation that is wanted or otherwise desirable, or can crowd outinformation that is more wanted or otherwise more desirable relative tothe additional information that is inputted into the audible spectrum. Asimilar concept applies to vision prostheses where an increase inbrightness can crowd out information that is more desirable and moreuseful to the recipient relative to the additional information that isinputted due to the increase in brightness.

Accordingly, in an exemplary embodiment, block 345 changes the Q valueof the hearing prosthesis depending on given scenarios. By way ofexample only and not by way limitation, in an exemplary embodiment, in ascenario where the recipient is utilizing the hearing prosthesis whileat a zero level of fatigue, the third operating regime can entailoperating the hearing prosthesis with a Q value of for example 10, whichis typically what is utilized in a standard quiet setting. In anexemplary embodiment, the Q value of the third regime can be or is lessthan 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, or anyvalue or range of values therebetween.

Still further by way of example only and not by way limitation, in anexemplary embodiment, in a scenario where the recipient is utilizing thehearing prosthesis while at a first level of fatigue, the firstoperating regime can entail operating the hearing prosthesis with a Qvalue of, for example, 20, which is typically what is utilized in astandard noisy setting. In an exemplary embodiment, the Q value of thefirst regime can be or is less than 15, 16, 17, 18, 19, 20, 21, 22, 23,24, 25, 26, 27, 28, 29, or 30 or any value or range of valuestherebetween. Still further by way of example only and not by waylimitation, in an exemplary embodiment, in a scenario where therecipient is utilizing the hearing prosthesis while at a second level offatigue, the second operating regime can entail operating the hearingprosthesis with a Q value of for example 30, which is typically what isutilized in a very noisy setting. In an exemplary embodiment, the Qvalue of the first regime can be or is less than 20, 21, 22, 23, 24, 25,26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, or 40, or anyvalue or range of values therebetween.

Thus, in view of the above, in an exemplary embodiment, the hearingprosthesis is configured to operate in an operating regime where a Qfactor of the prosthesis is larger relative to that which is the case inanother operating regime.

Still further with respect to FIG. 3, the output side processing 300further includes channel emphasis block 350. As noted above, in someexemplary embodiments of the prostheses detailed herein and/orvariations thereof, the input is divided up into channels, such as byway of example, by the filter block. Channel emphasis block 350 canemphasize some of these channels over others. Indeed, in an exemplaryembodiment, channel emphasis block 350 emphasizes some channels byeliminating other channels, or more specifically, eliminating the outputof one or more given channels from the output of the output sideprocessing 300. Still further, in an exemplary embodiment, channelemphasis block 350 can emphasize some channel(s) by reducing themagnitude/amplitude of the output signal of some channel(s) relative toothers, instead of eliminating those channel(s) entirely. Corollary tothis is in that in at least some exemplary embodiments, channel emphasisblock 350 can emphasize some channels by increasing themagnitude/amplitude of the output signal of some channel(s) relative toothers, all other things being equal.

In an exemplary embodiment, there can be scenarios where the informationon one or more given channels is deemed more useful to a recipient theninformation on one or more other channels. However, the information onthe one or more other channels makes it more difficult to understand theinformation on the one or more channels where the information is deemedmore useful, at least relative to the scenario where if the informationin those other channels that is deemed not as useful were not present.Accordingly, in an exemplary scenario, channel emphasis block 350 can beutilized to operate the hearing prosthesis such that one or morechannels are emphasized over one or more other channels (which includesdeemphasizing, including eliminating, channels) with respect to theoutput of the output side processing 300.

Accordingly, in an exemplary embodiment, block 350 is utilized indifferent manners depending on the given fatigue level or lack thereofof the recipient. In an exemplary embodiment, channel enhancementapplied during the third operating regime is a standard channelenhancement implementation, although in some other embodiments, thethird regime entails no channel enhancement whatsoever (on the outputside—this can still be present on the input side). Still further, in anexemplary embodiment, channel enhancement applied during the firstoperating regime is a moderate channel enhancement as compared to thatapplied during the third operating regime. In an exemplary embodiment,during the first operating regime, one or two channels may beeliminated, whereas only one channel or no channels may have beeneliminated during the third operating regime.

It is noted that in some embodiments where the recipient is at thesecond fatigue level, the moderate channel enhancement regime isutilized as well. Conversely, in some alternate embodiments, where therecipient is at the second fatigue level, as well as the first fatiguelevel, the aggressive channel enhancement implementation is utilized.(In an exemplary embodiment, aggressive channel enhancement can entailcancelling more channels than that which was the case in the moderatechannel enhancement.) That said, in some alternate embodiments, standardchannel enhancement or no channel enhancement is utilized while at thezero fatigue level and at the first fatigue level, and the moderate oraggressive channel enhancement is utilized at the second fatigue level.

While the above exemplary embodiment has focused on the elimination ofchannels, in an alternate embodiment, standard channel enhancement (suchas that which can correspond to that utilize during the third operatingregime) can entail amplifying certain channels by a first amountrelative to others, moderate channel enhancement can entail amplifyingcertain channels by a second amount relative to others different thanthe first amount (which includes amplifying some channels less than thatwhich was the case during the standard channel enhancement), and can infact entail amplifying certain channels by a second amount relative toothers while canceling other channels entirely, etc.

In view of the above, in an exemplary embodiment, the hearing prosthesiscan be operated in an operating regime where the hearing prosthesislimits a resulting perceptual frequency relative to that which is thecase in another operating regime.

As noted above, the present teachings have been described in terms of asense prosthesis in general, and a hearing prosthesis and a visionprosthesis, in particular. Still further, embodiments are directedtowards implantable prostheses, as distinguished from, for example,non-implanted prostheses. For example, a pair of glasses or aconventional hearing aid corresponds to a non-implantable prosthesis.Corollary to this is that in at least some exemplary embodiments, theteachings detailed herein and/or variations thereof are implemented withrecipients that are clinically and/or legally blind and/or deaf, asthose phrases have meaning as of Mar. 15, 2016, in any one of the UnitedStates, Canada, any given country that is a member of the EuropeanPatent Convention, Japan, the People's Republic of China, the Republicof Korea, as the case may be with respect to the filing of thisapplication. Still further, the teachings detailed herein and/orvariations thereof are implemented with recipients that are U.S. SocialSecurity Administration Classified as legally blind and/or deaf, asthose phrases have meaning as of Mar. 15, 2016, with respect to theSocial Security Administration of the United States of America. That is,the teachings detailed herein are implemented in recipients that meetthe requirements for obtaining Social Security benefits because therecipient is legally deaf and/or legally blind.

Thus, the embodiments of a pair of glasses and a conventional hearingaid have little, if any, utilitarian value with respect to suchrecipients, at least with respect to evoking a vision percept and/orevoking a hearing percept.

Thus, at least some exemplary embodiments are directed towardsimplementing any or all of the teachings detailed herein with respect toan implantable device. Accordingly, FIG. 10 depicts an exemplary method1000 of operation of a implanted prosthesis, such as a retinal implant,a cochlear implant, a middle ear implant, or a bone conduction implant(including those that have a vibrator located outside the recipient buta component that is implanted beneath the skin of the recipient/insidethe recipient). The method 1000 includes method action 1010, whichentails operating the implanted hearing prosthesis during a firsttemporal period. Method 1000 further includes method action 1020, whichentails, in a second temporal period subsequent to the first temporalperiod, operating the implanted hearing prosthesis differently than theway that the prosthesis was operated during the first temporal period,because the recipient has less cognitive capacity relative to that whichwas the case during operation of the prosthesis during the firsttemporal period.

By way of example only and not by way of limitation, a cognitivecapacity can correspond to the ability of the recipient to understandimplant evoked speech percepts, all things being equal. That said, insome alternate embodiments, a cognitive capacity can correspond to theability of the recipient to understand implant evoked speech percepts,under the influence of a given environmental stimulus, and such can berelative to the ability of the recipient to do this without theinfluence of the given environmental stimulus, all other things beingequal. Thus, cognitive capacity can be a function of fatigue, andcognitive capacity can also be a function of the environment. Forexample, a recipient under the influence of caffeine, alcohol, or drugs,including but not limited to prescription drugs, can have a cognitivecapacity that is different than that of the exact same recipientutilizing the exact same hearing prosthesis, all other things beingequal. Still further, environmental conditions are not limited toconditions that are directly mind altering. In an exemplary embodiment,environmental conditions that can affect cognitive ability include heat,cold, a distracting environment (loud noises, a person one findsattractive being in visual range in a manner that makes clear reasonsfor the attraction, distracting actions occurring, such as largeprotests against political leaders, etc.). Indeed, as can be understood,cognitive capacity can be unrelated to fatigue—the caffeine example canrender the recipient unfatigued. Note further that in exemplaryembodiments, cognitive capacity can be influenced by both theenvironment and fatigue. Also, cognitive capacity can be influenced bypsychological conditions that are not induced by environment. Acompletely unfatigued recipient (one at the zero level of fatigue) whois completely isolated from outside stimuli at the current time canstill have reduced cognitive abilities relative to other temporalperiods because he or she is simply having “a bad day.” Any scenariothat can result in diminished cognitive capacity with respect to theability of the recipient to perceive or otherwise understand the contentof the evoked hearing percepts can be a stimulus for such.

At this time it is noted that in an exemplary embodiment, the varying ofthe aforementioned operating regimes can have utilitarian value withrespect to reducing the cognitive load applied to the recipientvis-à-vis the evoked hearing percepts for a given amount of contentextraction there from. Still further, the varying of the aforementionedoperating regimes can have utilitarian value with respect toaccommodating the recipient as the recipient becomes more fatigued. Withrespect to utilizing different processing strategies, ACE vs. ACE withMP3 subscript 000 vs. some other processing strategy, the processingstrategy that will be utilized will be the one that is easier to userelative to that which is the case for the other fatigue levels, eventhough the content may not be as “good” as that which might otherwise bethe case.

With respect to the embodiments detailed above with respect to variouslevels of fatigue and lack of a level of fatigue, any method detailedabove that utilizes fatigue and/or lack of a fatigue as a scenarioqualifier can be transposed to methods that utilize cognitive level as ascenario qualifier. By way of example only and not by way of limitation,with respect to the method 500, the first fatigue level can correspondto a first diminished cognitive level where the cognitive capacity tounderstand or otherwise comprehend the information embodied in theevoked hearing percept and/or visual percepts relative to that which isthe case a prior temporal period. Accordingly, zero fatigue level can betransposed to a zero diminished cognitive capability level. On theopposite end of the spectrum, the second fatigue level can correspond toa diminished cognitive capacity to understand or otherwise comprehendthe information embodied in the evoked hearing percept and/or visualpercepts relative to that which was the case at the first diminishedcognitive level. This is not to say that as used herein diminishedcognitive capacity corresponds to fatigue. Just the opposite. Asdetailed above, diminished cognitive capacity can exist without fatigue.Accordingly, the two are different. The transposition with respect tocognitive capacity and fatigue is simply presented in a manner that isshorthand for what otherwise would correspond to the above disclosuresassociated with methods 400-700 being repeated below in terms ofcognitive capacity as opposed to fatigue. Thus, for purposes ofshorthand, the disclosure herein of a first operating regime correspondsto operating the prosthesis such that the information provided to therecipient takes less cognitive capacity to process than that which isthe case when the prosthesis is operated during at the third operatingregime, all things being equal. Still further, for the purposes ofshorthand, the disclosure herein of a second operating regimecorresponds to operating the prosthesis such that information providedto the recipient takes less cognitive capacity to process than thatwhich is the case with respect to when the prosthesis is operated at thefirst operating regime, all things being equal, and visa-versa. Stillfurther, for the purposes of shorthand, the disclosure herein of thefirst fatigue level corresponds to a first cognitive capability level,the disclosure herein of the second fatigue level corresponds to asecond cognitive capability that is lower than that of the firstcognitive capability, and the disclosure herein of the zero fatiguelevel corresponds to a cognitive capability level that is maximumrelative to the other levels. Again, this is simply for purposes ofshorthand. This is not to say that they are the same. This simplyeliminates the need to reproduce much of the above in terms of cognitivecapability.

It is noted that some embodiments correspond to utilizing theembodiments detailed herein with respect to a cochlear implant. It isfurther noted that some exemplary embodiments correspond to utilizingthe embodiments detailed with respect to a retinal implant.

To be clear, while the embodiments of method 1000 detail two differenttemporal periods in a manner analogous to the method 400 detailed above,other embodiments can include three different temporal periods whereeach respective temporal period includes a cognitive capacity that isdifferent from the other, and where each temporal period following theother results in a level of cognitive capacity that is lower than thatwhich was the case during the prior temporal period. In this regard,FIG. 11 presents method 1100. Method 1100 includes method action 1110,which entails executing method 1000. Method 1100 further includes methodaction 1120, which entails operating the implanted hearing prosthesisdifferently during a third temporal period than the way the prosthesiswas operated during method action 1010 and method action 1020, becausethe recipient has less cognitive capacity relative to that which was thecase during operation of the prosthesis during the first and secondtemporal periods of method 1000. Accordingly, this can entail thejuxtaposition of the second fatigue level in the teachings detailedabove with the cognitive capabilities of the temporal period detailed inmethod 1120.

In an exemplary embodiment, with respect to method 1000, the firsttemporal period and the second temporal period at least have portionsthat fall within the same eight hour period. Note further that withrespect to the third temporal period of method 1100, that third temporalperiod can also have portions that fall within the same eight hourperiod (which would mean that all of the second temporal period fallswithin that eight hour period. That said, instead of an eight hourperiod, embodiments can include a 16 hour temporal period or a 24-hourtemporal period or a 48 hour period in which portions of theaforementioned temporal periods fall within.

It is noted that, for the purposes of shorthand, the disclosure hereinof the recipient having various fatigue levels and the zero fatiguelevel corresponds to respective temporal periods of the method 1100.This is not to equate the two groups. This is only to avoid repeatingswaths of text in terms of the features of methods 1000 and 1100.

Corollary to the aforementioned shorthand statements is that the aboveshorthand regimes also apply in reverse. For example, any disclosureherein of a given temporal period corresponds to the correspondingfatigue levels and the zero fatigue levels, where the zero fatigue levelcorresponds to the first temporal period, the first fatigue levelcorresponds to the second temporal period, and the second fatigue levelcorresponds to the third temporal period.

It is noted that the embodiments of methods 1000 and 1100 can beimplemented with respect to operating the prosthesis differently, eventhough the cognitive capacity of the recipient has not been changed. Inthis regard, in an exemplary embodiment, during the first temporalperiod, an environment of the recipient changes. By way of example onlyand not by way of limitation, in an exemplary embodiment, the room inwhich the recipient is positioned becomes noisier. Still further by wayof example only and not by way of limitation, in an exemplaryembodiment, a speaker to which the recipient is focusing his or herattention stops speaking, and that speaker is replaced by anotherspeaker who speaks in a manner that is not as clear as the originalspeaker. In an exemplary embodiment of method 1000, during a thirdtemporal period (not to be confused with the above noted third temporalperiods, as this is with respect to a method that has not encountered athird temporal period—again, these are naming conventions only) afterthe change in the environment, the method includes the action ofoperating the implanted hearing prosthesis differently than the way theprosthesis was operated before the environment of the recipient changed.Again, in this embodiment, the cognitive capacity of the recipient isthat of the first cognitive capacity during the third temporal period.In an exemplary embodiment, the operation of the prosthesis can be suchthat the prosthesis is operated according to any of the first and secondregimes detailed above relative to the third regime detailed above.Thus, an embodiment entails adjusting or otherwise changing theoperation of the hearing prosthesis even though the cognitive capacityof the recipient has not changed. Still, in this embodiment, this iscoupled with a corollary adjustment or otherwise change in the operationof the hearing prosthesis, because the cognitive capacity of therecipient has changed. Still further, while this embodiment focuses onthe change in the environment during the first temporal period, inanother embodiment, this can include a change in the environment duringthe second temporal period where the cognitive capabilities of therecipient have not changed. Note further that the scenario can occurduring the first temporal period and during the second temporal periodand during the third temporal period (with respect to method 1100), forthat matter. Accordingly, in an exemplary embodiment, the recipientmight find himself or herself adjusting the prosthesis so that it takesless cognitive effort to understand, at least in general terms, theinformation that is contained in the hearing percept and/or in thevisual percept as the case may be, five times or more.

That said, in at least some exemplary embodiments, with respect to thethird temporal period resulting from the environmental change detailedabove, in an exemplary embodiment, the operation of the hearingprosthesis during the third temporal period is the same as the operationof the hearing prosthesis during the second temporal period. This canbe, for example, the case in the scenario where at least one of prior tothe beginning of the second temporal period or during the secondtemporal period, the environment of the recipient changes back to thatwhich was the case during the first temporal period. For example, thescenario can include a situation where the cognitive capabilities of therecipient do decline, but for example, the speaker who is more difficultto understand has stopped speaking, and the speaker who is lessdifficult to understand has commenced speaking again. Thus, even thoughthe recipient has less capability to understand what is being said,because the speech is clear, the recipient need not, or otherwise doesnot, find it utilitarian to compensate for his or her decliningcognitive capabilities by operating the hearing prosthesis in adifferent manner.

Note that in keeping with the utilization of shorthand to reduce theamount of text in this application, this concept also corresponds to ascenario where the recipient remains at a first level of fatigue, asecond level of fatigue, or a zero level of fatigue, but the environmentchanges while at these various levels of fatigue and/or the zero levelof fatigue.

FIG. 12 presents another exemplary embodiment of an exemplary method,method 1200. Method 1200 includes method action 1210, which entailsprocessing first captured sounds on an output side of a sound processor(e.g., that of output side processing 300 of FIG. 3) of a hearingprosthesis to evoke a first artificial hearing percept in a recipientwhile the hearing prosthesis is in a first mode. Method 1200 furtherincludes method action 1220, which entails second processing secondcaptured sounds with the output side of the sound processor to evoke asecond artificial hearing percept in the recipient while the hearingprosthesis is in a second mode. In the embodiment of method 1200, allthings being equal, the second processing is such that the recipientmust devote less effort to generally understand the captured sounds thanthat which is the case with the first processing. It is noted that withrespect to less effort, this is a relative phrase because it isqualified by the all things being equal caveat. In this regard, if therecipient had the same cognitive capability during the period of thefirst processing and the second processing, less effort would berequired to generally understand the second processing (or moreaccurately, the hearing percept that is evoked due to the secondprocessing). This means that in an exemplary embodiment, the recipientmay still have to devote more effort to understanding the hearingpercept than that which was the case with respect to the hearingpercepts resulting from the first sound processing, such as by way ofexample that which may be the case with respect to the fact that thecognitive capabilities of the recipient have decreased from the firstartificial hearing percept and the second artificial hearing percept orby that which may be the case with respect to the fact that therecipient has grown more fatigued etc. With respect to method 1200, itis just that if the recipient had the same level of fatigue with thesame cognitive capabilities at the times that the first and secondartificial hearing percepts were evoked, the recipient would have todevote less effort to generally understanding the captured sounds.

In an exemplary embodiment, the first mode can correspond to the thirdoperating regime, and the second mode can correspond to the first orsecond operating regimes detailed above. In some alternativeembodiments, the first mode can correspond to the first operatingregime, and the second mode can correspond to the second operatingregime.

FIG. 13 represents another method, method 1300, corresponding to anexemplary embodiment. Method 1300 includes method action 1310, whichentails executing method 1200. Method 1300 further includes methodaction 1320, which entails third processing third captured sounds withthe output side of the sound processing system of the hearing prosthesisto evoke a third artificial hearing percept in the recipient while thehearing prosthesis is in a third mode. To be clear, it is noted that theaforementioned second mode and the aforementioned third mode aredifferent from each other, and are different than the aforementionedfirst mode. In an exemplary embodiment, the second mode corresponds tothe first operating regime, the third mode corresponds to the secondoperating regime, and the first mode corresponds to the third operatingregime. In an exemplary embodiment, all things being equal, the thirdprocessing is such that the recipient must devote less effort togenerally understand the captured sounds than that which is the casewith the second processing.

FIG. 14 represents another method, method 1400, corresponding to anexemplary embodiment. Method 1400 includes method action 1410, whichentails executing method 1300. Method 1400 further includes methodaction 1420, which entails fourth processing fourth captured sounds withthe output side of the sound processing system of the hearing prosthesisto evoke a fourth artificial hearing percept in the recipient while thehearing prosthesis is in a fourth mode. In an exemplary embodiment, allthings being equal, the fourth processing is such that the recipientmust devote less effort to generally understand the captured sounds thanthat which is the case with the third processing.

It will be understood that embodiments of the methods detailed hereincan include repeating method 1400 to evoke a fifth captured hearingpercept utilizing fifth processing, etc. where the fifth processingrequires less effort than the fourth processing all things being equal,etc.

FIG. 15 depicts a flowchart for another exemplary method, method 1500.Method 1500 includes method action 1210, which corresponds to methodaction 1210 detailed above. Method 1500 further includes method action1520, which entails determining that using the hearing prosthesis in thefirst mode is tiring. In an exemplary embodiment, this is executed bythe recipient himself or herself. In an alternate exemplary embodiment,this can be determined by the hearing prosthesis itself, as will beexplained in some additional detail below. Method 1500 further includesmethod action 1530, which entails changing the hearing prosthesis fromthe first mode to the second mode. As can be seen from FIG. 15, method1500 further includes method action 1220, which corresponds to methodaction 1220 detailed above. It is to be understood that in analternative embodiment, method 1500 can be expanded to repeat methodactions 1520 and 1530 after method action 1220, albeit with respect tochanging the prosthesis from the mode that it is currently into yetanother mode, where this other mode is less tiring, or otherwiserequires less effort to generally understand the captured sounds, allthings being equal. It is to be understood that in further alternateembodiments, this concept can be further from more modes as the casewill be.

A variety of reasons can prompt the recipient to implement method 1200,1300, 1400, and/or 1500 (or any of the other methods detailed herein).In an exemplary embodiment, between method 1210 and method 1220, withrespect to methods 1200 and 1500, an environmental change occurs thatcauses utilization of the hearing prosthesis in the first mode to bemore tiring than that which was the case prior to the environmentalchange, all other things being equal. In this regard, by way of exampleonly and not by way of limitation, the recipient can be exposed to analcoholic beverage or otherwise the utilization of some form of drugsprescription or otherwise. Still further by way of example only and notby way of limitation, the recipient can be exposed to a more noisyenvironment and/or a speaker to which the recipient is listening isremoved and another speaker who speaks less clearly has been presentedin place of the former speaker. The recipient could simply be in a moredistracting environment. It is noted that in an exemplary embodiment,the cognitive capabilities of the recipient between method action 1210and method action 1220 remain the same. That said, in an alternativeembodiment, the cognitive capabilities the recipient between methodaction 1210 and method action 1220 change such that the recipient hasless cognitive capability with respect to method action 1220 than he orshe did with respect to method action 1210. This is also the case withrespect to fatigue. This concept is also applicable to methods 1300 and1400 as well.

FIG. 16 presents a functional schematic of an exemplary prosthesis 1600,or at least a portion thereof, according to an exemplary embodiment. Inan exemplary embodiment, the prosthesis 1600 corresponds to the retinalimplant detailed above, while in other embodiments the prosthesis 1600corresponds to the cochlear implant detailed above with respect toFIG. 1. That said, in some alternate embodiments, the prosthesis isanother type of prosthesis, such as by way of example only and not byway of limitation, a middle ear implant or a bone conduction deviceimplant. In an exemplary embodiment, the prosthesis 1600 includes aprocessor 1610, which in an exemplary embodiment, can be a lightprocessor and/or a sound processor. The processor 1610 receives a signal1640 indicative of input that is based upon a captured physicalphenomenon, such as sound, light, etc. The processor 1610 processes theinput 1640, and outputs a signal 1612 that is based on the processedinput to tissue stimulator 1620. In an exemplary embodiment, tissuestimulator 1620 is configured to stimulate the tissue to evoke a hearingpercept based on the signal 1612. This is represented by output arrow1650, which represents the output of stimulative energy to tissue of therecipient. In an exemplary embodiment, the output is an electricalsignal, such as the case with respect to the output of an electrode of aretinal implant and/or a cochlear implant.

Prosthesis 1600 further includes an input unit 1630, which is configuredto receive input indicative of a dynamic cognitive capability of arecipient. In an exemplary embodiment, input unit entails a toggleswitch or the like that is configured so that the recipient can depressthe switch so as to provide input, represented by input 1660, into theinput unit. The input unit 1630 is in signal communication with theprocessor 1610 via signal path 1632. In an exemplary embodiment, theinput unit 1630 receives the input 1660 from the recipient thatindicates that the recipient is of a certain dynamic cognitive capacity(more on this below). In an exemplary embodiment, the input unit 1630receives the input 1660 from the recipient indicating that the recipientwants the prosthesis to operate differently from that which it iscurrently operating, because, for example, the cognitive capability ofthe recipient has changed and/or because the recipient has becomefatigued and/or because the sound and/or light that the recipient isreceiving requires more cognitive effort specifically or effort ingeneral to comprehend, all other things being equal. That said, as willbe detailed below, input unit 1630 further includes, in someembodiments, the capability to receive input indicative of latentvariables or the like that are indicative of the recipient becomingfatigued, the recipient having less cognitive capability than that whichwas previously the case and/or that the sound and/or light to which therecipient is being exposed requires more effort to comprehend.

Briefly, still with reference to FIG. 16, it can be seen that the inputunit 1630 is in communication with the sound processor 1610 via signalline 1632, which will enable the input unit 1630 to provide input to thesound processor so that the sound processor processes sounds in adifferent manner according to the teachings detailed herein, whichcorresponds to a different operating regime and/or different operatingmode and/or operating the prosthesis differently. Also as can be seenfrom FIG. 16, the input unit 1630 is in communication with the tissuestimulator 1620 via signal line 1634. In an exemplary embodiment, inputunit 1630 can communicate directly with the tissue stimulator 1620, and,in some embodiments, control the tissue stimulator 1620 so that theprosthesis 1600 operates differently. That is, the input unit 1630bypasses the processor 1610 and the input unit 1630 in combination withthe tissue stimulator 1620 changes the operating regimes of theprosthesis 1600. In an exemplary embodiment, this can entail theelimination of certain channels from being outputted by the tissuestimulator 1620. In an exemplary embodiment, this can entail theprevention of energizement of one or more electrodes of an electrodearray where the tissue stimulator 1620 is a cochlear electrode array. Itis noted that the input unit 1630 can work with both the processor 1610and the tissue stimulator 1620 at the same time to achieve any of theresults detailed herein and/or variations thereof.

Accordingly, in an exemplary embodiment, the prosthesis 1600 isconfigured to receive input indicative of a dynamic cognitive capacityof a recipient and/or input indicative of a dynamic fatigue state of therecipient. In an exemplary embodiment, as noted above, the recipient candepress a button on the prosthesis that is part of input unit 1630. Inan exemplary embodiment, the prosthesis is configured such that thedefault is to operate in the third regime as detailed above. That is,upon commencement of the utilization of the prosthesis 1600, theprosthesis operates in the third regime unless input is inputted intothe prosthesis. Subsequently, the recipient becomes fatigued to thefirst level and/or recognizes that he or she has experienced a cognitivecapability declined relative to that which was the case at thecommencement of utilization of the prosthesis 1600. Accordingly, therecipient can provide input into the input unit 1630, such as bydepressing a button on the input unit, indicating such. Upon receipt ofthis input, the prosthesis is configured to transition from the thirdoperating regime to the first operating regime. Subsequently, therecipient becomes fatigued to the second level and/or recognizes that heor she has experienced a cognitive capability decline relative to thatwhich was the case at the time that the recipient previously inputtedthe information regarding the fatigue and/or cognitive capabilitydeclined just noted. Accordingly, the recipient can provide input intothe input unit 1630, such as by depressing the button on the input unit,indicating such. The prosthesis is configured to recognize that thebutton has been depressed a second time, and therefore, upon suchrecognition, the prosthesis is configured to transition from the firstoperating regime to the second operating regime.

Note that additional operating regimes can be utilized after the secondoperating regime that entailed further downshifting of the variouscapabilities of the hearing prostheses with respect to the output sideprocessing 300. Thus, as noted above, there could be a fourth operatingregime in which the prosthesis operates that requires even lesscognitive effort to generally comprehend the content of the input 1640.There could be additional operating regimes, each operating regime beingor otherwise corresponding to a further downshifting of the prosthesis1600. That said, in the embodiment where there are only three operatingregimes, the prosthesis 1600 is configured such that the third time thatthe button of the input unit 1630 is depressed, the prosthesis revertsback to the third operating regime. In an exemplary embodiment, theprosthesis 1600 interprets the third depression of the button of theinput unit 1630 as indicating that the recipient is at a zero fatiguelevel and/or at the maximum cognitive capability level and/or that theenvironment in which the recipient is in is such that the recipientrequires relatively little effort to comprehend the input relative tothat which was previously the case.

While the embodiments detailed above has been presented in adigital/discreet manner, in some alternate embodiments, the input 1630can be utilized in more of an analog manner. In an exemplary embodiment,the recipient can turn a knob that gradually adjusts the prosthesisthrough different operating regimes, although even that has a modicum ofdigitality thereto. Note further that in an exemplary embodiment, theprosthesis 1600 can be configured such that the recipient can controlone or more or all of the various output side processing featuresdetailed above. By way of example only and not by way of limitation, inan exemplary embodiment, the recipient can adjust the number of spectralmaxima on his or her or her own to the exact number that he or she findsacceptable. In an exemplary embodiment, the recipient could adjust thepulse rate to that which he or she finds acceptable. Any of theparameters that can be adjusted detailed herein can be individuallyadjusted in some embodiments.

It is noted that in at least some exemplary embodiments, the inputrequired to adjust these specific features could become voluminous. Inthis regard, in an exemplary embodiment, the prosthesis 1600 can beconfigured to communicate with a portable handheld electronic device,such as by way of example, a so-called smart phone and/or a so-calledlaptop computer. Such devices can enable more ease of management and/ormore ease of input of the various parameters that can be adjusted asdetailed herein and/or other parameters that can be adjusted to accountfor fatigue and/or for varying cognitive capacity, and/or for input thatrequires more effort.

The term “downshifting” has been used herein to describe the changes tothe operation of the hearing prosthesis. In this regard, the term“downshifting” is meant to mean that the prosthesis is operated in amanner such that the prosthesis operates in a less than optimal matterfor conditions that would otherwise warrant the more optimized matter.In this regard, this differentiates from a scenario where, for example,a hearing prosthesis is changed from an Omni directional mode to abeamforming or directional capture mode because that scenario warrantssuch operation. Conversely, downshifting would entail utilizingbeamforming or directional capture mode even though the situation wouldotherwise not call for such, solely because the recipient has becomefatigued and/or the recipient has experienced reduced cognitivecapability. It is noted that the term “downshifting” as used hereincorresponds to short-term changes to address short-term fatigue and/orcognitive fluctuations. This in a manner analogous to utilizing avehicle at a lower gear setting for a specific reason. A long-termchange would be analogous to devoting a car or truck to utilization on asteep mountainside where, for example, the car or truck would always beoperated in first gear.

Still further, the term downshifting as used herein is directly tied tothe current state of the recipient whether that is an affirmative inputby the recipient or a determination by the prosthesis based on latentvariables or the like. To be clear, this differentiates fromestablishing or otherwise operating the prosthesis in a given operatingregime because the recipient has that specific cognitive capability on along-term basis and/or has a mental condition that warrants such in amanner analogous to fatigue (e.g., a very rich and successful hearingimpaired person with knowledge or talent that people will stand in thecold rain for hours to acquire may not care if he or she does not pickup nuances of voice in a given operational regime because thatoperational regime “pains” the recipient—here, the recipient viewsutilizing the prosthesis at that operational regime as tiring orfatiguing, and just does not care if people have to repeat themselves 3or 4 times—this as distinguished from someone who adjusts the operatingregime because he or she has become tired at that limited temporalperiod or he or she is not as cognitively sharp as previously was thecase).

Another way of qualifying some of the teachings detailed herein is thatthe recipient can adjust the operational regimes of the prosthesis toachieve an output thereof that is more manageable than other operationalregimes. By analogy, one goat is easier to herd than two goats, twogoats are easier to herd than three goats, three goats are easier toherd than for goats etc., all other things being equal. In the samevein, less information/less content in the output 1650 of the prosthesisis easier to manage than more content, all other things being equal.

The embodiments detailed above have focused on recipient input as aconscious act into input 1630. As noted above, in an alternateembodiment, the prosthesis can utilize latent variables to determine orotherwise indicate that the recipient is at a fatigue level and/or thatthe recipient has experienced a change in his or her dynamic cognitivecapabilities and/or that a change has occurred in an environment thatrequires more effort to comprehend the given input relative to thatwhich was the case, all other things being equal.

It is noted that in an exemplary embodiment, the prosthesis 1600 alone,and/or in combination with another external device, such as a smartphone and/or a laptop computer, is configured with software, and/orhardware, and/or firmware, or the like to “learn” from the recipient andextrapolate when the recipient is more likely to be fatigued and/or whenthe recipient is more likely to experience a diminished cognitivecapability relative to other instances.

In an exemplary embodiment, the prosthesis is configured to record, on atemporal basis, the changes made to the operating regimes of theprosthesis. For example, a college student may become more fatiguedduring a 10:00 AM class than that which was the case at an 8:30 AMclass. Over the course of a number of occurrences of the recipientchanging the prosthesis from one operating regime to the other operatingregime, the prosthesis can extrapolate a pattern, and therefore canconfigure itself to automatically adjust to the pertinent operatingregime at the pertinent time without the recipient having to provideinput to the recipient. Here, in an exemplary embodiment, the prosthesiscan provide a signal to the recipient indicating that such has beenperformed, and the recipient can override such if he or she seeks to doso. In an alternate embodiment, the prosthesis provides no indication ofthe recipient, and the recipient can override such if he or she seeks todo so. Accordingly, in an exemplary embodiment, the prosthesis isconfigured to remember the prior “downshiftings” or the like, and canextrapolate a scheduled therefrom and implement such. Note further thatin an exemplary embodiment, instead of automatically implementing such,the prosthesis can present the schedule to the recipient, and can askthe recipient to agree to the schedule and/or ask for modifications tothe schedule. Such can be enabled via a portable handheld electronicdevice, or the like.

While the above embodiment has been detailed in terms of a reoccurringscenario that can be temporally correlated, other embodiments canutilize a reoccurring scenario that is correlated to other features,such as temperature, ambient noise, geography (e.g., a GPS can beutilized to determine location and/or correlation between, cell phonetowers can be utilized to determine location—the prosthesis can“remember” the geographic locations where the recipient provided inputto the prosthesis to downshift or the like, and develop a geographicschedule based therefrom, etc.). Still further, in an exemplaryembodiment, the prosthesis can “learn” that downshifting occurs as aresult of certain frequencies predominating an input to the prosthesis(e.g., speech frequencies, flesh colored frequencies, etc.). Theprosthesis thus correlates the downshifting to the level of fatigue orthe level of cognitive capability experienced by the recipient at thetime of downshifting.

In an exemplary embodiment, the prosthesis 1600 can be configured toextrapolate a pattern based on a level and/or duration of ambient noise.In an exemplary embodiment, if the duration of ambient noise extends forcertain temporal period, and the recipient frequently or otherwisestatistically significantly changes or otherwise downshifts theprosthesis after the noise is extended to that temporal period, theprosthesis can be configured to extrapolate that pattern and thenautomatically downshift upon the occurrence of the noise for thattemporal period. In an exemplary embodiment, the recipient mightdownshift two or more levels for a given period, or might downshiftgradually with respect to the length of the noise. Any correlationbetween the length and/or volume of noise and the recipient's fatigueand/or cognitive capabilities that can enable the teachings detailedherein and/or variations thereof to be practiced can be utilized in atleast some exemplary embodiments.

Still further, in an exemplary embodiment, the prosthesis canextrapolate fatigue level and/or cognitive capability from the speech ofthe recipient. In an exemplary embodiment, the rate of speech/words canbe an indicator of fatigue and/or cognitive capability and/or the effortto which the recipient is placing towards listening or seeing. Stillfurther, in an exemplary embodiment, the voice level can be an indicatorof fatigue and/or cognitive capability and/or the effort to which therecipient is placing towards listening or seeing. With regard to thelatter, in an exemplary embodiment, a voice stress analysis can beutilized, where increased stress indicates that more effort is beingapplied to listening or seeing. In an exemplary embodiment, theprosthesis can correlate input 1660 by the recipient into the input unit1630 with these latent variables and can train itself to automaticallydownshift upon such occurrences.

As can be seen, in an exemplary embodiment, the training or the like isbased on semi-random events that when collected together, can establisha pattern that can be utilized for automatic operational adjustment.That is, the events are dictated by the recipient's lifestyle, and therecipient's lifestyle is for the most part established because therecipient has the ability to artificially hear and/or artificially see.That is, the events are not associated with training or otherwiseoptimizing the hearing prosthesis, but instead are events that occurduring normal life, which events occur while the recipient has differentfatigue levels and/or no fatigue levels and/or has different cognitivecapabilities, and in many instances, from one occurrence of the sameevent to another occurrence of the same event, and the operation of thehearing prosthesis is modified accordingly to accommodate therecipient's state during those events.

Note further that in some exemplary embodiments, fatigue can bedetermined utilizing body movements, and/or other physiologicalfeatures, such as output from an accelerometer which analyzes therecipient's activity. Note further that with respect to FIG. 16, it isnoted that the input into input unit 1630 not only includes input by therecipient via the pushbuttons detailed above or the like, but alsoincludes input that is not initiated by the recipient, such as the inputfrom the accelerometer just described. Note further that input into theinput unit 1630 can flow from the capture device. By way of example, themicrophone 210 can provide input into the input device 1630. The inputdevice 1630 can also be a control unit or the like where a processor inand of itself processes this input and extrapolates data from the input(e.g., that the frequencies captured by the microphone are primarilyvoice frequencies, etc.) and utilizes that to develop the aforementionedautomatic downshifting routines of the like. Accordingly, as can be seenin FIG. 16, the input 1640 is also fed to the input unit 1630 via signalline 1633. That said, input into the input unit 1630 can also beprovided from the processor 1610 via signal line 1632. In this regard,the results of processing can be utilized by the input unit 1630 toascertain or otherwise extrapolate a level of fatigue and/or level ofcognitive capability and/or a level of effort associated withcomprehending the information that is captured by the prostheses. In asimilar vein, input unit 1630 is in communication with tissue stimulator1620. The input unit 1630 can evaluate information from the tissuestimulator, and extrapolate a level of fatigue and/or a level ofcognitive capability and/or a level of effort associated withcomprehending the information that is captured by the prosthesis basedon how the prosthesis is going to evoke a percept based on theinformation captured by the prosthesis.

In view of the above, FIG. 17 presents an exemplary method 1700. Method1600 includes method action 1610, which entails executing any of methods400, 500, 600, 700, 1000, 1100, 1200, 1300, 1400, and/or 1500 (or anyother method detailed herein or portion thereof) a plurality of timesand recording data associated with the prosthesis related to at leastsome actions of those methods (e.g., the operating regime to which theprosthesis was changed, the stimulation rate to which the prosthesis waschanged) and other data (e.g., time, date, geographic location, etc.).Method 1700 further includes method action 1720, which entailsevaluating the data recorded in method action 1710. This can be doneautomatically by the thesis and/or by a remote electronic device. In analternative embodiment, this can be performed by a third-party where thedata recorded in action 1710 is provided to an off-site location wherethe data is evaluated. Accordingly, in at least some exemplaryembodiments, method action 1620 can be substituted for the action ofproviding the data recorded in method action 1710 to a party so that itcan be evaluated. Method 1700 further includes method action 1730, whichentails automatically executing one or more the method actions ofmethods 400, 500, 600, 700, 1000, 1100, 1200, 1300, 1400, and/or 1500,or any other methods detailed herein or portions thereof based on theevaluation of action 1720. In an exemplary embodiment, between action1720 and action 1630, there can be an action of programming or otherwisereconfiguring the prosthesis such that the one or more method actions ofmethods 400, 500, 600, 700, 1000, 1100, 1200, 1300, 1400, and/or 1500,or any other methods detailed herein or portions thereof are executedautomatically. Accordingly, there exists a prosthesis that is programmedor otherwise configured so as to execute method 1730 automatically.

In view of the above, it can be understood that in an exemplaryembodiment, the teachings detailed herein and/or variations thereof canhave utilitarian value with respect to enabling a recipient to meet asubjective minimum level of information acquisition an understandingwhile preventing any additional unnecessary effort associated withlistening and/or seeing. That is, in an exemplary embodiment, theprosthesis is configured so as to varyingly provide the “minimum”information that a recipient desires without more.

Note further that the converse is the case in some exemplaryembodiments. In an exemplary embodiment, the hearing prosthesis isconfigured to enable the recipient to upshift so as to obtain more thana subjective minimum. Accordingly, exemplary embodiments include methodswhere after the downshifting there is a subsequent upshifting, either tothe ultimate upshift operating regime (e.g., the third operating regimedetailed above where the prosthesis is operating at maximum utility), orto an operating regime that provides the ability to extract more fromthat evoked hearing percept but not the maximum utility. Corollary tothis is that some embodiments include methods where the cognitivecapability of the recipient increases and/or the recipient becomes lessfatigued, hence the upshifting.

As detailed above, there is utilitarian value in modifying the outputside processing based on fatigue and/or cognitive load and/or the effortassociated with comprehending or otherwise listening and/or viewing,utilizing the various prostheses detailed herein. Corollary to this isthat in an exemplary embodiment, there is utilitarian value in applyingsuch strategies to the ultimate output of a given prosthesis on asystematic level. Now with respect to a hearing prosthesis, FIG. 1800functionally represents a bimodal and a hybrid hearing prosthesis (thetwo are different, but for the purposes of this disclosure, the diagramof FIG. 18 can be utilized to convey the pertinent teachings associatedwith both systems). In this exemplary embodiment, input 1810 is providedto a main component 1820 of the prosthesis, which main component is insignal communication with tissue stimulator subsystem 1830 and tissuestimulator subsystem 1840 as can be seen. In an exemplary embodiment,tissue stimulator subsystem 1830 includes a separate tissue stimulatorthan that of tissue stimulator subsystem 1840. In an exemplaryembodiment, subsystem 1830 corresponds to a first cochlear implantelectrode array and associated stimulator unit, and subsystem 1840corresponds to a second cochlear implant electrode array and associatedstimulator unit. Each subsystem is utilized for the respective ear ofthe recipient. In another exemplary embodiment, subsystem 1830corresponds to a first type of hearing prosthesis, such as by way ofexample only and not by way of limitation, a cochlear implant, a middleear implant, an inner ear mechanical stimulator, a bone conductiondevice, or a conventional acoustic hearing aid. In this exemplaryembodiment, subsystem 1840 corresponds to a second type of hearingprosthesis different than that of the subsystem 1830 in an exemplaryembodiment, for purposes of discussion, the first subsystem 1830 is aconventional acoustic hearing aid, and the second subsystem 1840 is acochlear implant. In some embodiments, the subsystems are utilized inthe same ear (e.g., there is residual hearing in an ear in which thecochlear election array is implanted).

Main component 1820 receives an input signal 1810 in a traditionalmanner (e.g., utilizing a microphone or plurality of microphones, etc.)and processes that input signal so that the various subsystems 1830 and1840 can operate accordingly. In an exemplary embodiments utilizing theacoustic hearing aid in combination with a cochlear implant,low-frequency sound will be directed to the acoustic hearing aid 1830(or more accurately, main component 1820 will divide up the input signal1810 so as to output a signal to the acoustic hearing aid to evoke ahearing percept at those lower frequencies), and high-frequency soundwill be directed to the cochlear implant 1840 (or more accurately, maincomponent 1820 will divide up the input signal 1810 so as to output asignal to the cochlear implant to evoke a hearing percept at thosehigher frequencies). It is noted that the main component 1820 caninclude a sound processor configured to develop control signals for bothsubsystems 1830 and 1840. That said, in an alternate embodiment, maincomponent 1820 is bifurcated between two components that operateindependently of one another. Any arrangement that will enable thepractice of a hybrid and/or a bimodal hearing prosthesis can be utilizedin at least some exemplary embodiments.

In an exemplary embodiment, in a scenario where the recipient is at oneor more of the fatigue levels detailed herein and/or in a scenario wherethe recipient is at a cognitive level of reduced capacity relative tothat of other levels, and/or in a scenario where more effort is requiredto comprehend the input 1810, the subsystem 1840 can be shut down orotherwise disabled. In such an exemplary embodiment, this could meanthat no high-frequency hearing percepts will be evoked by the prosthesis1800. In an alternative embodiment, subsystem 1840 can operate in areduced mode, where the intensity of the output of the subsystem isreduced (e.g., gain adjustments can be made to the subsystem 1840). Itis noted that this can be done across the board for subsystem 1840, or,the more targeted features detailed above can be implemented withrespect to subsystem 1840 (for example, the number of spectral maximasmay be reduced, the stimulation rate can be reduced, etc.).

In an alternate embodiment, subsystem 1830 can operate in the reducedmode.

Still further, in an exemplary embodiment, one or more subsystems (it isnoted that while the embodiment of FIG. 18 depicts two subsystems, morethan two subsystems can be included in some exemplary embodiments) canbe operated in a reduced mode (which includes being shut downcompletely). In an exemplary embodiment, a recipient may have betterhearing in one ear versus the other. In an exemplary embodiment, thesubsystem(s) evoking hearing percepts for the inferior ear might beoperated in a reduced mode so that the recipient does not put effort (orat least significant effort) into hearing with that ear or otherwiseputs less effort into hearing with that ear than is otherwise the case.

Indeed, in an exemplary embodiment, one or more of the subsystems canoperate in a mode that evokes a hearing percept that is configured torelax the recipient or otherwise render the recipient less fatigued,where one or more of the other subsystems operate in the mode thatprovides information to the recipient and evokes a hearing percept toaccomplish such. Still further, in an exemplary embodiment, thesubsystem can operate in a mode that does not evoke a conscious hearingpercept, but stimulates the nerves in a manner that is relaxing to therecipient's nervous system. Any manner of operating one subsystemdifferently than the other subsystem in a manner differently than thatwhich would otherwise be the case, all things being equal, as a resultof the recipients fatigue level and/or the absence thereof and/or therecipients cognitive capability or a change thereof or otherwise due tothe effort associated with listening can be utilized in at least someexemplary embodiments.

It is noted that in an exemplary embodiment, where frequencies or othercontent are bifurcated between the two subsystems or trifurcated betweenthree subsystems, etc., there can be utilitarian value with respect tofolding back the content that would otherwise be present in a givensubsystem into one of the other subsystems. By way of example only andnot by way of limitation, a recipient may find the content of thecochlear implant to be easier to comprehend, but not as “fulfilling” asthe content of a middle ear stimulator. In an exemplary embodiment, themiddle ear stimulator can be shut down and all of the content can besupplied to the cochlear implant. In an exemplary embodiment, therecipient may find that the cochlear implant is harder to listen to orotherwise takes more effort than the acoustic hearing aid, even thoughthe recipient has little to no residual high-frequency hearing. In anexemplary embodiment, the prosthesis 1800 shuts down the cochlearimplant, and provides the content that would otherwise be provided bythe cochlear implant to the acoustic hearing aid, albeit at a lowerfrequency of which the recipient can hear (i.e., a frequencycorresponding to the residual hearing of the recipient).

It is noted that while the teachings detailed above have typically beendirected towards the “output side processing” of the hearing prosthesis,some embodiments can be directed towards management of the input sideprocessing and/or management of the pre-input side processing withrespect to hybrid and/or bimodal prostheses. For example, one of thesubsystems can be implemented using input that is different from anotherof the subsystems. In an exemplary embodiment, the cochlear implantsubsystem can utilize directional sound capture and/or beamforming,while the acoustic hearing aid subsystem can utilize omnidirectionalsound capturing. Such can be done, for example, in a scenario where therecipient finds the acoustic hearing aid easier or less effortful toutilize. That said, in a scenario where the recipient finds the cochlearimplant to be easier or less effortful to utilize, the omnidirectionalsound capture can be utilized therefore, and thebeamforming/directionality sound capture can be used for the acoustichearing aid.

Some exemplary input side processing that can be different includesnoise cancellation and/or feedback cancellation routines. In anexemplary embodiment, the operating regimes of the prosthesis cancorrespond to utilizing different such routines depending on the levelof fatigue or lack thereof of the recipient and/or depending on thecognitive ability of the recipient and/or depending on how much effortis associated with comprehending the evoked hearing percepts. By way ofexample only and not by way of limitation, adaptive signal processingassociated with noise cancellation, including body noise cancellation,can be varied between the subsystems. For example, the attack time of anadaptive system can be varied depending on the fatigue and/or cognitivecapabilities of the recipient, etc.

It is noted that any method detailed herein also corresponds to adisclosure of a device and/or system configured to execute one, or more,or all of the method actions associated therewith detailed herein. In anexemplary embodiment, this device and/or system is configured to executeone, or more, or all of the method actions in an automated fashion. Thatsaid, in an alternate embodiment, the device and/or system is configuredto execute one, or more, or all of the method actions after beingprompted by the recipient.

It is noted that embodiments include non-transitory computer-readablemedia having recorded thereon a computer program for executing one ormore or any of the method actions detailed herein. Indeed, in anexemplary embodiment, there is a non-transitory computer-readable mediahaving recorded thereon, a computer program for executing at least aportion of at least one of the methods detailed herein/one or more orall method actions detailed herein.

It is further noted that any device and/or system detailed herein alsocorresponds to a disclosure of a method of operating that device and/orusing that device. Furthermore, any device and/or system detailed hereinalso corresponds to a disclosure of manufacturing or otherwise providingthat device and/or system.

While various embodiments of the present invention have been describedabove, it should be understood that they have been presented by way ofexample only, and not limitation. It will be apparent to persons skilledin the relevant art that various changes in form and detail can be madetherein without departing from the spirit and scope of the invention.

What is claimed is:
 1. A method, comprising: operating a senseprosthesis according to a first operating regime during a first temporalperiod while the recipient has a first fatigue level; and operating thesense prosthesis according to a second operating regime during a secondtemporal period different from the first temporal period while therecipient has a second fatigue level that is greater than the firstfatigue level, wherein the second operating regime results in providinga different information to the recipient than that which would have beenprovided by the first operating regime, all other things being equal. 2.The method of claim 1, further comprising: operating the senseprosthesis according to a third operating regime while the recipient isat a zero fatigue level.
 3. The method of claim 2, further comprising:receiving input from the recipient indicating that the recipient isfatigued; and changing the sense prosthesis from the third operatingregime to the first operating regime.
 4. The method of claim 3, furthercomprising: subsequent receiving input from the recipient indicatingthat the recipient is fatigued, receiving input from the recipientindicating that the recipient is more fatigued; and changing the senseprosthesis from the first operating regime to the second operatingregime.
 5. The method of claim 1, wherein: the sense prosthesis is aretinal implant.
 6. The method of claim 1, wherein the second operatingregime provides less content to the recipient than the first operatingregime, all other things being equal.
 7. The method of claim 1, whereinthe second operating regime results in providing a different amount ofinformation to the recipient than that which would have been provided bythe first operating regime, all other things being equal.
 8. The methodof claim 1, wherein: the second regime results in a more or lessaggressive cancellation of an adaptive cancellation system of theprosthesis than the first regime.
 9. The method of claim 1, wherein: thesense prosthesis is a bimodal hearing prosthesis or a hybrid hearingprosthesis; the sensed prosthesis includes a first sub-system thatincludes a first tissue stimulator; and the action of operating thesense prosthesis during the second operating regime includes limitingthe output of the first sub-system such that a hearing percept includesless features from the first sub-system and more features from anotherportion of the bimodal hearing prosthesis or the hybrid hearingprosthesis relative to that which would have been provided by the firstoperating regime, all other things being equal.
 10. The method of claim1, wherein: the sense prosthesis is a bimodal hearing prosthesis systemor a hybrid hearing prosthesis system; the sensed prosthesis includes afirst sub-system that includes a first tissue stimulator; the senseprosthesis includes a second sub-system that includes a second tissuestimulator; the action of operating the sense prosthesis during thefirst operating regime is such that the first sub-system operatesaccording to a first sub-system first operating regime and the secondsub-system operates according to a second sub-system first operatingregime; and the action of operating the sense prosthesis during thesecond operating regime is such that the first sub-system operatesaccording to a first sub-system second operating regime and the secondsub-system operates according to a second sub-system second operatingregime.
 11. The method of claim 1, wherein: the sense prosthesis is abimodal hearing prosthesis system or a hybrid hearing prosthesis system;the sensed prosthesis includes a first sub-system that includes a firsttissue stimulator; the sense prosthesis includes a second sub-systemthat includes a second tissue stimulator; the action of operating thesense prosthesis during the first operating regime is such that thefirst sub-system operates according to a first sub-system firstoperating regime and the second sub-system operates according to asecond sub-system first operating regime; and the action of operatingthe sense prosthesis during the second operating regime is such that thefirst sub-system operates according to a first sub-system secondoperating regime and the second sub-system does not operate the secondtissue stimulator.
 12. A method, comprising: operating an implantedsensory prosthesis during a first temporal period by at least in partprocessing environmental input; and in a second temporal periodsubsequent to the first temporal period, operating the implantedprosthesis differently than the way that the prosthesis was operatedduring the first temporal period because the recipient has lesscognitive capacity relative to that which was the case during operationof the prosthesis during the first temporal period, wherein theoperation of the implanted prosthesis during the second temporal periodincludes at least in part processing environmental input.
 13. The methodof claim 12, wherein: the implanted prosthesis is a cochlear implant.14. The method of claim 12, wherein: the prosthesis is operated duringthe second temporal period such that there is more ambient environmentmitigation than that in the first temporal period.
 15. The method ofclaim 12, wherein: the prosthesis is operated during the second temporalperiod such that a different environmental input processing strategy isutilized than that in the first temporal period.
 16. The method of claim12, wherein: during the first temporal period, an environment of therecipient changes; and during a third temporal period after the changein the environment, operating the implanted prosthesis differently thanthe way the prosthesis was operated before the environment of therecipient changed, wherein the cognitive capacity of the recipient isthat of the first temporal period during the third temporal period. 17.The method of claim 16, wherein: the operation of the prosthesis duringthe third temporal period is different than the operation of the hearingprosthesis during the second temporal period.
 18. The method of claim12, wherein: the implanted prosthesis is a cochlear implant; a recipientof the cochlear implant is utilizing a non-cochlear implant hearingprosthesis during the first temporal period; and during the secondtemporal period, content of one of the cochlear implant or non-cochlearimplant is folded back relative to that which would have been the casein the absence of the folding back.
 19. A method, comprising: firstprocessing first captured environmental inputs during a first temporalperiod on an output side of a environmental input processing system of asense prosthesis to evoke a first artificial sensory percept in arecipient while the prosthesis is in a first mode; and second processingsecond captured environmental inputs during a second temporal periodwith the output side of the environmental input processing system evokea second artificial sensory percept in the recipient while theprosthesis is in a second mode, wherein all things being equal, thesecond processing is such that the recipient must devote more effort togenerally understand the captured environmental inputs than that whichis the case with the first processing.
 20. The method of claim 19,wherein: between the first processing and the second processing, it isdetermined that the cognitive capability of the recipient has increased,and based on that determination, the prosthesis is changed from thefirst mode to the second mode.
 21. The method of claim 20, wherein:between the first processing and the second processing, a cognitivecapability change occurs that causes utilization of the prosthesis inthe first mode to be less tiring than that which was the case prior tothe change, all other things being equal.
 22. The method of claim 19,wherein: the effort is cognitive effort.
 23. The method of claim 19,wherein: in the second mode, the prosthesis increases a number ofspectral maxima in an output signal to a tissue stimulator thatstimulates tissue to evoke the sensory percepts relative to that whichis the case in the first mode.
 24. The method of claim 19, wherein: inthe second mode, the prosthesis increases a resulting stimulation rateof a tissue stimulator that stimulates tissue to evoke the sensorypercepts relative to that which is the case in the first mode.
 25. Asense prosthesis comprising: an environmental input processing system;and a tissue stimulator configured to stimulate tissue to evoke asensory percept based on processed environmental input from theprocessor, wherein the prosthesis is configured to process firstcaptured environmental inputs during a first temporal period on anoutput side of the processing system to evoke a first artificial sensorypercept in a recipient while the prosthesis is in a first mode; and theprosthesis is configured to process second captured environmental inputsduring a second temporal period with the output side of the processingsystem evoke a second artificial sensory percept in the recipient whilethe prosthesis is in a second mode, wherein all things being equal, thesecond processing is such that the recipient must devote a differentamount of effort to generally understand the captured environmentalinputs than that which is the case with the first processing.
 26. Thehearing prosthesis of claim 18, wherein: the hearing prosthesis isconfigured to receive direct input indicative of a dynamic cognitivecapacity of a recipient directly from a recipient of the hearingprosthesis; and the hearing prosthesis is configured to automaticallyswitch from the first mode to the second mode based on the direct input.27. The hearing prosthesis of claim 18, wherein: the hearing prosthesisis configured to receive input indicative of a dynamic cognitivecapacity of a recipient directly from a recipient of the hearingprosthesis; the hearing prosthesis is configured to automatically switchfrom the first mode to the second mode if the input indicative of thedynamic cognitive capacity indicates a reduction in cognitive capacity,wherein the second processing is such that the recipient must devote aless amount of effort to generally understand the captured environmentalinputs than that which is the case with the first processing.
 28. Thehearing prosthesis of claim 18, wherein: the hearing prosthesis isconfigured to receive input indicative of a dynamic cognitive capacityof a recipient directly from a recipient of the hearing prosthesis; thehearing prosthesis is configured to automatically switch from the firstmode to the second mode if the input indicative of the dynamic cognitivecapacity indicates an increase in cognitive capacity, wherein the secondprocessing is such that the recipient must devote a greater amount ofeffort to generally understand the captured environmental inputs thanthat which is the case with the first processing.
 29. The hearingprosthesis of claim 18, wherein; the hearing prosthesis is configured toreceive input indicative of a dynamic cognitive capacity of a recipientbased on latent variables; and the hearing prosthesis is configured toautomatically switch from the first mode to the second mode based on theinput indicative of a dynamic cognitive capacity.
 30. The hearingprosthesis of claim 18, wherein; the hearing prosthesis is configured toquantitatively vary output of the tissue stimulator when transitioningfrom the first mode to the second mode.